[Pulmonary actinomycosis: caused by Actinomyces odontolyticus?]. / Actinomycose pulmonaire: responsabilité d'Actinomyces odontolyticus?

Primary pulmonary actinomycosis is a purulent bronchopulmonary disease mimicking tuberculosis. The histological lesions contain characteristic yellow granules. The organism most frequently responsible for the disease is Actinomyces israeli. We report the first case to our knowledge where Actinomyces odontolyticus seems to be involved.

Two cases of Actinomyces pyogenes infection in humans.

Few confirmed human cases of Actinomyces pyogenes infection have been reported partly because of inadequate identification of this bacterium. In this study, two new cases are reported with emphasis on the characteristics which are relevant for identification of the isolates. A review of previously reported cases is presented.

Balneatrix alpica gen. nov., sp. nov., a bacterium associated with pneumonia and meningitis in a spa therapy center.

In 1987, an outbreak of pneumonia and meningitis caused by an unknown bacterium occurred in a spa therapy centre. Nine isolates of this pathogen constituted a tight DNA hybridization group. rRNA-DNA hybridization and 16S rRNA sequencing showed that the studied bacteria represented a new branch in superfamily II (= gamma subclass) of the Proteobacteria, close to the genus Oceanospirillum. The new bacterium was highly polymorphic and, in young cultures, had curved Gram-negative cells, motile by polar single flagella. The new bacterium differed from the genus Oceanospirillum by its lacking the NaCl requirement and by reducing nitrate into nitrite, producing indole from tryptophan and producing acid from carbohydrates. The name Balneatrix alpica gen. nov., sp. nov. is proposed for the studied organism. The type strain is strain 4-87 (= CIP 103589).

Rhodococcus equi infection in patients with AIDS.

Rhodococcus equi is an emerging opportunistic pathogen of HIV-I infected patients. It is an aerobic, Gram-positive coryneform bacterium which acts as a facultative intracellular micro-organism, multiplying in the phagosome of macrophages. Eighteen cases of R. equi infection in HIV-I positive patients have now been reported. Sixteen of these had pneumonia, of which 12 had cavitating lung lesions. A history of contact with farm animals, which are the primary hosts of R. equi, was found in only three patients. There was a delay in establishing a definite diagnosis in most cases as this depended upon the isolation of R. equi from sputum, bronchoalveolar lavage fluid, or blood. Treatment included surgical resection in five patients and erythromycin with a second antibiotic in 13 cases, but II of the 18 patients died from the infection. In this report we describe our experience of R. equi pneumonia in two AIDS patients and review the published cases of the disease in man.

An outbreak of pneumonia and meningitis caused by a previously undescribed gram-negative bacterium in a hot spring spa.

An outbreak of infection caused by a previously undescribed Gram-negative bacterium affected people attending a hot (37 degrees C) spring spa in France in 1987. Thirty-five case of pneumonia and two cases of meningitis occurred. None of these patients died. Attack rates were significantly higher for patients above 70 years old and for male patients. An epidemiological comparison of the 26 hospitalized cases with 52 matched controls suggests that spa treatment early on the first day (OR = 4.8) and attendance at the vapour baths (OR = 10.7) were significant risk factors for acquiring the infection. Person-to-person spread was not thought to have occurred. The same bacterium was isolated from the hot spring water. All strains studied shows a single rRNA gene restriction pattern. Epidemiological data indicated that the thermal water was the source of infection. This outbreak stresses the need for increased surveillance of infections in people attending hot spring spas.

Pneumonia and meningitis caused by a new nonfermentative unknown gram-negative bacterium.

Seven isolates of an unclassified bacterium resembling Flavobacterium spp. were characterized by growth requirements, microscopic examination, biochemical characteristics, antimicrobial susceptibility tests, protein profile analysis, and serologic data. The unclassified isolates were differentiated from Flavobacterium meningosepticum, Flavobacterium odoratum, Flavobacterium balustinum, Flavobacterium strain IIb, Chromobacterium violaceum, Aquaspirillum serpens, and Pseudomonas spp. The bacterium was a gram-negative rod with a polar flagellum. Protein profile analysis demonstrated two major protein bands present in the unclassified isolates that were absent from the Flavobacterium and Pseudomonas controls but present in the Aquaspirillum and Chromobacterium controls. However, no serologic cross-reactions were observed. Our results showed that the unclassified bacterium was distinct from any previously known genus of bacterium.

[Micromethods and gas chromatography analysis of carboxylic acids produced from the fermentation of glucose in the identification of Corynebacteria]. / Apport des microméthodes et de l'analyse en chromatographie en phase gazeuse des acides carboxyliques issus de la fermentation du glucose dans l'identification des corynébactéries.

The identification of fermentative Corynebacteria currently isolated from human specimens is not very easy, even with the use of the useful guide edited by Hollis and Weaver. The purpose of this investigation is to present a classification based on the study of a large number of biochemical characters, including the use of micromethods, and the characterization of carboxylic acids produced from dextrose fermentation by gas-liquid chromatography. The results show that it is possible to classify fermenting Corynebacteria into two groups based on the production of propionic acid or the lack of it. We are thus able to separate distinctly Corynebacteria whose biochemical characters are very similar. Likewise, some tests included in the micromethods are useful for separating the species.

Meningitis due to Micrococcus luteus.

We are presenting a new case of meningitis due to the Micrococcus luteus species. This germ was isolated twice in eight days from the CSF of a 57-year old woman. The patient had a ventriculoperitoneal shunt implanted for hydrocephalus following a meningeal haemorrhage. Antibiotic therapy was efficient but the patient died of a recurrent haemorrhage.

[Opportunistic bacteria]. / Les bactéries opportunistes.

The definition of opportunistic bacteria is based on two parameters: the receptive subject and the bacteria. When the receptive subject is normal, theoretically, no saprophytic or normal commensal organisms are able to invade the subject. This subject can only be infected by certain "undesirable" commensal organisms such as Vargues' Specific Pathogenic Bacteria. If an otherwise normal subject has a temporary decrease in his immune defences, he may be invaded by a number of organisms from the normal commensal flora: these are the opportunistic bacteria in the broad sense of the term. The immunosuppressed patient with profound and prolonged depression of his immune system may be attacked by various saprophytic organisms and a number of commensal organisms, even those which were previously considered to be non-virulent. These are the opportunistic infections in the strict sense of the term.

[Pathogenic role of Actinomyces apart from actinomycosis. Apropos of 2 cases of acute suppurations with Actinomyces odontolyticus]. / Le rôle pathogène des Actinomyces en dehors de l'actinomycose. A propos de deux cas de suppurations aiguës contenant Actinomyces odontolyticus.

The authors report two cases of acute suppurative lesions due to Actinomyces odontolyticus. They point out the fairly high incidence of this pathogen in such conditions, either isolated or more often as part of a mixed flora. Conversely, Actinomyces odontolyticus is only exceptionally recovered in true actinomycosis.

[Campylobacter fetus fetus bacteremia. Review of the literature apropos of 2 cases]. / Bactériémie à Campylobacter foetus foetus. Revue de la littérature à propos de deux cas.

The authors report two cases of bacteremia due to Campylobacter fetus fetus (also called C. fetus intestinalis). One was a 22-year-old female, under treatment for active systemic lupus erythematosus, who died. The other was a fifty-year-old male, in a poor general condition, who had a self-limited acute febrile dysentery. In this patient, C. fetus fetus was found in stools after apparent recovery, raising the problem of healthy carriers. A review of the literature shows 64 other such cases.

[Atrophic rhinitis and Klebsiella ozaenae. Reflections apropos of a case]. / Rhinite atrophique et Klebsiella ozaenae. Réflexions à propos d'un cas.

The authors report a case of atrophic rhinitis associated with Klebsiella ozaenae. The literature is reviewed. This pathogen could be involved in both respiratory tract infections and systemic diseases. The relationship between Klebsiella ozaenae and ozena is discussed.

[Septicemia due to Leptotrichia buccalis in an immuno-suppressed patient]. / Septicémie à Leptotrichia buccalis chez un immunodéprimé.

The authors report a case of septicemia due to Leptotrichia buccalis in a patient with underlying lymphatic leukemia. It is the second case reported in the literature. This observation shows, once again, that bacteria known as "non virulent" can exhibit pathogenicity in immunosuppressed patients.

[Fusobacterium necrophorum associated with Actinomyces odontolyticus septicemia ]. / Septicémie mixte à Fusobacterium necrophorum associé à Actinomyces odontolyticus.

The authors have observed a case of Fusobacterium necrophorum associate with Actinomyces odontolyticus septicemia, which appears to be the first case reported. In a 19 year old man, 15 blood cultures allowed to isolate both germs. Clinical manifestations were: acute-like abdomen, encephalitis, myocarditis and pleural effusion. Treatment with amoxicillin and metronidazole was successful.