ABSTRACT
A 40-year-old soldier in Guyana consulted at the end of December for skin lesions that had been developing for several weeks after he was lost overnight in the equatorial forest, near the village of Saul. He was bitten by numerous mosquitoes during the night and as he crossed marshy areas. When he arrived at the clinic he had 23 leishmaniasis sites visible.
Subject(s)
Leishmania guyanensis/isolation & purification , Leishmaniasis, Mucocutaneous/diagnosis , Adult , Animals , Forests , Guyana , Humans , MaleABSTRACT
Scorpion envenomation is common in northern Chad and associated with a high lethality rate. We report the management of 16 cases of scorpion envenomation in 2014 at our Faya-Largeau medical post. Our clinical experience revealed dissociated muscarinic symptoms in patients treated early in contrast to those treated later, who presented cardiogenic shock. In the absence of antivenom, patients with an isolated muscarinic syndrome received small doses of atropine, and their signs and symptoms improved afterwards. Although the use of atropine is controversial, the question here is about using it to treat muscarinic symptoms of scorpion envenomation in the absence of severe hypertension and with no signs of heart failure.
Subject(s)
Antivenins/therapeutic use , Scorpion Stings/drug therapy , Scorpion Venoms/antagonists & inhibitors , Adult , Chad , Child , Child, Preschool , HumansABSTRACT
In December 2013, the most widespread epidemic of Ebola virus disease began in Guinea and continued for over 2 years. At the request of the Guinean state, France deployed a military field hospital to treat Ebola infected healthcare workers. From January to July 2015, our center supported 26 healthcare workers suffering from Ebola virus disease. Despite an individualized care and optimal treatment, the fatality rate remained high at 30.7%. Improved therapies are required to reduce mortality risk in Ebola virus disease. We report the case of a patient admitted to the hospital on the 4th day after onset, who survived despite several clinical and biological predictors of fatal outcome. We transfused plasma at a high dose and spread over time. This innovative therapeutic approach was based on our clinical experience of Ebola patients' management, literature review and knowledge of plasma ability to restore coagulation disorders and endotheliopathy. Even without any bleeding sign, coagulopathy and endothelial permeability disorders participate in hypovolemia and fatal multi-system organ failure. Early intake of therapeutic plasma at repeated doses seems to reduce the endothelial permeability and coagulation disorders related to Ebola virus disease.
Subject(s)
Blood Component Transfusion , Hemorrhagic Fever, Ebola/therapy , Plasma , Amides/therapeutic use , Anti-Bacterial Agents/therapeutic use , Blood Preservation , Combined Modality Therapy , Disease Management , Freeze Drying , Gastrointestinal Agents/therapeutic use , Hemorrhagic Fever, Ebola/drug therapy , Humans , Male , Pyrazines/therapeutic use , Severity of Illness Index , Young AdultABSTRACT
Despite their rarity, some causes of retroperitoneal granulomatous tumor must be kept in mind. We report a 41-year-old man who presented with a right psoas mass. No spondylitis was associated. The patient had never travelled. He had never eaten foreign exotic fresh aliments. Serology and specific PCR were positive for brucellosis. The course was favorable after a percutaneous drainage and a combined antibiotic therapy (rifampin and doxycycline). Brucellosis is close to be eradicated in France. The large majority of new French cases result from accidental laboratory contamination or from a journey abroad. This case report highlights the possibility of excessively rare native brucellosis cases in France.