[Isolated pleural amebiasis: about one case in France]. / Amibiase pleurale isolée.

INTRODUCTION: Isolated pleural amebiasis is exceptional in the world and specially in France. CASE REPORT: We report a case of acute isolated pleural amebiasis in a 56 year old man who did not travelled in endemic countries for the 20 past years. Chocolate-colored pus from the pleural puncture suggested the diagnosis. Positive amebic serology and above all, trophozoites (Entamoeba histolytica) in the pleural liquid confirmed the diagnosis of pleural amebiasis. Drainage was required and metronidazole was introduced. Other antibiotics were necessary to treat bacterial co-infection, which is frequent. Of interest, a nurse developed an acute intestinal amebiasis probably infected by pleural pus, an indirect confirmation of diagnosis. CONCLUSION: This diagnosis should be suspected even in low endemic areas in case of infectious pleurisy resistant to traditional antimicrobial regimens.

[Tuberculosis and HIV infection: experience of the national tuberculosis prevention program in Djibouti: 1990-1996]. / Tuberculose et infection VIH l'experience du programme national de lutte antituberculeuse de Djibouti: 1990-1996.

Based on analysis of data collected from the national tuberculosis prevention program in Djibouti between 1990 and 1996, the authors analyzed the relationship between HIV infection and tuberculosis. The study cohort comprised a total of 22,000 patients including 14,000 with documented HIV infection. Although HIV infection probably worsened the situation, it was neither the only nor the main factor involved in the resurgence of tuberculosis. Demographic growth, higher population density, and increasing poverty as well as the quality of the national tuberculosis prevention program must be taken into account. The incidence of smear-negative tuberculosis was not significantly higher in HIV-infected patients (incidence of smear positive cases, > 92%). Extrapulmonary tuberculosis especially of pleural involvement was more common (15% versus 9.4%). Treatment was effective in HIV-infected patients. If directly observed (DOT) therapy was used, there was no risk of emergence of multidrug-resistant tuberculosis strains. Drug side-effects associated with the protocols used in Djibouti were not greater in HIV-infected patients. Most additional mortality observed in HIV-infected tuberculosis patients (10.5% versus 2%) was due to progression of HIV infection.

[The eosinophilic lung]. / Le poumon éosinophile.

Infiltration of the pulmonary parenchyma by eosinophils is revealed in bronchoalveolar washings. Associated with pulmonary biopsy, this technique has renewed the approach to a classical syndrome. Pulmonary infiltration eosinophilia has multiple etiologies: some are well characterized (parasitic or medicinal), some others pose some nosological or etiopathogenic problems not yet clarified (chronic pulmonary infiltration eosinophilia, vasculitis of the lung). In such difficult cases, use of surgical pulmonary biopsies has to be envisaged.

[An outbreak of Schistosoma mansoni bilharziasis. 113 cases in a military unit returning from Central Africa]. / Une épidémie de bilharziose à schistosoma mansoni. 113 observations dans une collectivité militaire au retour d'Afrique centrale.

The authors report on an outbreak of Schistosoma mansoni infestation involving 113 military men who had been contaminated together in a tributary of the Chari river in the Central African Republic. The patients were examined on their return to France 50 days after being contaminated and were compared with a control group of 25 subjects who had lived in Africa under the same conditions but were exempt of bilharziasis. All were subjected to a retrospective questionnaire, physical examination, examination of the faeces and serological test for bilharziasis by indirect haemoagglutination. All received two courses of praziquantel. Follow-up serology was performed after 1 year in 86 cases. The results of this study in both groups are presented and commented upon. With intestinal bilharziasis, prophylaxis against contamination is extremely difficult to carry out in endemic areas among people who visit and work "on the spot". Detection by routine serology must be performed upon return.

[Relapse of an amebic abscess of the liver after treatment with metronidazole]. / Rechute in situ d'un abcès amibien du foie après traitement au métronidazole.

The authors report the observation of a twenty four years old soldier; subsequent to a stay in an endemic amoebic area, he showed several successive dysenteric episodes which were treated with metronidazole despite the absence of amoeba in the coprological examination. During one of these episodes, he presented a single rectal ulceration, then a hepatic abscess was observed four months later. The patient was treated with metronidazole and by contact amoebicides. In spite of that, amoeba were disclosed after a parasitological stool examination.