[Primary amebic meningoencephalitis: 1st case observed in Madagascar]. / Méningo-encéphalite primitive à amibes libres: 1er cas observé à Madagascar.

The primary amebic meningoencephalitis is an acute suppurative infection that involves both the brain and the meninges. It is caused by Naegleria fowleri and is a very rare and fulminating condition, so far nearly always fatal. We report the first case in the area of Southern part of Indian Ocean that occured in a 7-year old French boy living in Madagascar. It is assumed that the disease was contracted by swimming in warm fresh water in a lake of the Madagascar east coast. Clinical signs began 10-12 days after exposure, associating headache, vomiting and pyrexia (39-40 degrees C). Upon admission in a Madagascar hospital, the patient was started on antibiotics, that did not control the disease and soon presented with a loss of consciousness and a delirium. He was transferred to Reunion island (Centre Hospitalier Départemental Félix-Guyon), where the diagnosis of primary amebic meningoencephalitis was confirmed. Therefore, he was started on high-dose of intraspinal amphotericin B, IV amphotericin B lipid complex and tetracycline. He developed myocarditis, diabetes insipidus, deep coma and subsequently died a week later. The diagnosis of amebic meningoencephalitis was based on: -- the cerebrospinal fluid examination that confirmed the diagnosis of purulent meningitis: 420 leucocytes (76% polynuclears, 14% lymphocytes), 90 red blood cells, and showed 50 ameboid trophozoites per 100 leucocytes, approximately 20 microm in size. -- the flagellate transformation test in distilled water showed two anterior flagellas that confirmed the genus Naegleria.

Prospective assessment of a new polymerase chain reaction target (STEVOR) for imported Plasmodium falciparum malaria.

The diagnostic value of a polymerase chain reaction (PCR)-based method for amplifying a new target of repeated genes (STEVOR) in Plasmodium falciparum was prospectively assessed on samples from 210 febrile patients returning from areas endemic for malaria. This method is capable of detecting 0.01 parasites in one microliter of blood. Plasmodium falciparum STEVOR PCR confirmed the results of the thin- and thick-film direct examination method but identified Plasmodium falciparum in four patients in whom direct examination was inconclusive at the species level. Moreover, PCR was positive in two patients with a negative direct examination. Thus, Plasmodium falciparum STEVOR PCR had 100% sensitivity and specificity and could be used in selected parasitology laboratories when expert advice is required.

Strongyloides stercoralis infection in a non-immunosuppressed tourist with involvement of the central nervous system.

In the present case report a 50-year-old woman is presented with a Strongyloides stercoralis infection after a one-month stay in Sri Lanka. She showed a severe involvement of the central nervous system without a correlation of an immunosuppression. Strongyloides stercoralis is regarded as the cause of the cerebral involvement. Other possible causes are also discussed.

[Importance of Trichomonas tenax and Entamoeba gingivalis protozoa in the human oral cavity]. / Importance des protozoaires Trichomonas tenax et Entamoeba gingivalis dans la cavité buccale humaine.

Trichomonas tenax and Entamoeba gingivalis are protozoa found in the human oral cavity. Morphological and ultrastructural characteristics of those parasites were reviewed and then studied with the scanning electron microscope in this paper. Based on previous epidemiological studies, the relationship between periodontal disease and those protozoa was analysed. Evaluation of the pathogenicity of Trichomonas tenax and Entamoeba gingivalis was also part of the discussion of this study.

[Gel fractionation of immunoglobulins in the detection of specific antitoxoplasma IgM. Evaluation of a 1-year study]. / Apport du fractionnement sur gel des immunoglobulines dans la détection des IgM spécifiques antitoxoplasmiques. Bilan d'une année d'étude.

Toxoplasmosis seroconversion is diagnosed on the presence of fluorescent antibodies. IgG level kinetics and presence of IgM at the Remington test are usually the points taken in consideration. But the Remington test can be false positive, or inadequate. The authors report their experience of gel filtration of sera in toxoplasmosis, and discuss the help that this method can be establishing diagnosis in the case of a positive Remington test.

[Protozoa of the human oral cavity (epidemiological correlations and pathogenic possibilities]. / Les protozoaires de la cavité buccale humaine (corrélations épidémiologiques et possibilités pathogéniques).

The oral protozoa frequency has been studied in 300 patients consulting for oral problems. Entamoeba gingivalis has been isolated more frequently in culture than Trichomonas tenax (50.7% against 28%). The age range which showed the highest frequency in protozoa was the 30-34 year old group for the amoeba and the 45-54 year old group for the flagellae. The endemia increased progressively in relation to the OHIS index. Trichomonas tenax is three times more frequent in case of deep periodontal diseases whereas, Entamoeba gingivalis reached its highest frequency in the case of gingivitis. The pathogenic potentials of these protozoa have been discussed in the light of these correlations and some therapeutical arguments.

[Coprologic diagnosis of amebiasis : the rectocolitis cell trap and the value of cultures]. / Diagnostic coprologique de l'amibiase : le piège des cellules de recto-colite et l'intérêt des cultures.

The authors give the differential characters of dysenteric amoebae and cells observed in the feaces of patients affected by recto-colitis. In this purpose, they recall the usefullness of cultures for both the presence and the possibility of determination of the Amoebae. In short, they deplore the misappreciation of these advantages.

[Fasciola hepatica distomatosis in Maghreb. 2 new Algerian cases]. / La distomatose à Fasciola hepatica dans le Maghreb. A propos de deux cas algériens nouveaux.

A bibliographic survey is made of the cases of fasciolasis in Maghreb, and it can be concluded that: The notion of "epidemy", or better, of simultaneous cases, brought to the diagnosis evocation, to explorations by I.D.R. and to early treatment, before the excretion of eggs. Due to drug-efficiency, the coprological proof of the disease was generally missing in the old "epidemies" of the Maghreb. Isolated cases, in contrast, where the fasciolasic etiology was not evocated, could follow natural evolution and the proof by egg or adult discovery was possible in more than half the cases. Progress in immunology of fasciolasis made possible the diagnosis of less than 10 nw cases in Tunisia and Marocco. The authors report 2 new cases from the Constantine region (Algeria). The repartition of the ascertained cases and the possible ones is shown on a map.

[Epidemiology of free-living amoebae in the waters of Strasbourg (France) (author's transl)]. / Epidémiologie des amibes libres dans les eaux de Strasbourg.

164 strains of free-living amoebae were isolated from public drinking water supplies, swimming pools and official swimming ponds in Strasbourg; 11 genera and 16 species were identified. Some strains of Acanthamoeba are pathogenic for mice by intracerebral inoculation. Among the two strains of Naegleria found none is pathogenic. The results concerning free-living amoebae are compared with the level of chlorine and bromine and with the presence of bacteria in swimming pools.

[Study of free living amoebae in the waters of Strasbourg. Preliminary report (author's transl)]. / Etude des amibes libres dans les eaux de Strasbourg. Résultats préliminaires

75 strains of free living amoebae were isolated from public drinking water supplies, swimming pools and official swimming ponds in Strasbourg. 42 strains were identified till now. No pathogenic strain of Naegleria fowleri was found.