[Sacroiliitis with Erysipelothrix Rhusiopathiae revealing tricuspid endocarditis, the first case reported on the Guiana Shield: clinical case and review of the literature]. / Sacro-Iliite à Erysipelothrix Rhusiopathiae révélant une endocardite tricuspide, premier cas rapporté sur le bouclier des Guyanes : cas clinique et revue de la littérature.

We report here an atypical case of acute sacroiliitis caused by Erysipelothrix rhusiopathiae revealing tricuspid endocarditis in a 53-year-old woman without medical history. She was admitted to Cayenne hospital because of intense right hip and thigh pain, associated with fever. A right sacroiliitis was visible on the computed tomography (CT) scan, confirmed on MRI. Transesophageal echocardiography revealed a large mobile tricuspid vegetation. Blood cultures were positive for E. rhusiopathiae. CT scan showed pulmonary alveolar opacities, consistent with septic emboli. Clinical improvement was obtained under ceftriaxone followed by ciprofloxacin for 6 weeks of treatment. We present a review of bone and joint infections caused by E. rhusiopathiae. So far, not a single case has been reported in Latin America.

Spectrum of skin diseases in Amerindian villages of the Upper Oyapock, French Guiana.

BACKGROUND: Due to their genetic characteristics, their isolation in rainforest areas, and their traditional way of life, Amerindian populations are likely to suffer from a specific spectrum of dermatoses. However, there are few available data on such skin disorders. Our aims were to describe all skin disorders in two Amerindian villages of French Guiana. METHODS: This retrospective study concerned all patients who consulted in the Health Centres of Camopi and Trois-Sauts between July 1, 2017, and December 31, 2018. We included all patients classified with an ICD code linked to a skin disorder. All medical records were cross-checked by two dermatologists to correct misclassifications. RESULTS: A total of 639 patients formed the study population, for 866 different skin disorders. Non-sexually transmitted infections represented 57.6% of all skin disorders, followed by eczema (11.5%) and bites/envenomations (9.1%). Bacteria were responsible for 238 skin infections, followed by fungi (141 cases) and parasites (69 cases, including 43 scabies, nine cutaneous leishmaniasis, and two tungiasis). We reported a low prevalence of sexually transmitted infections (10 cases) and an absence of skin cancers. CONCLUSIONS: This study revealed the absence of skin cancer in the Amerindian population of the Upper Oyapock and the important burden of infectious and animal-related diseases. Future studies should assess a possible underestimation of sexually transmitted diseases in this area. Public health policies should target neglected diseases such as cutaneous leishmaniasis, tungiasis, scabies, and envenomations. Atopic dermatitis was a significant and unexpected cause of consultations.

Do Two Screening Tools for Chikungunya Virus Infection that were Developed among Younger Population Work Equally as Well in Patients Aged over 65 Years?

BACKGROUND: Chikungunya is an endemo-epidemic infection, which is still considered as an emerging public health problem. The aim of this study was to evaluate in a 65+ population, the accuracy of two chikungunya screening scores that were developed in younger people. METHODS: It was performed in the Martinique University Hospitals from retrospective cases. Patients were 65+, admitted to acute care units, for suspected Chikungunya virus infection (CVI) in 2014, with biological testing using Reverse Transcription Polymerase Chain Reaction. Mayotte tool and Reunion Island tool were also computed. Sensitivity, specificity, positive predictive value, negative predictive value, and Youden's statistic were calculated. RESULTS: In all, 687 patients were included, 68% with confirmed CVI, and 32% with laboratory-unconfirmed CVI. Fever (73.1%) and arthralgia (51.4%) were the most frequent symptoms. Sensitivity ranged from 6% (fever+headache) to 49% (fever+polyarthralgia); and Youden's index ranged from 1% (fever + headache) to 30% (fever+polyarthralgia). PPV and NPV ranged from 70% to 95%, and from 32% to 43%, respectively. CONCLUSION: Performances were very poor for both tools, although specificity was good to excellent. Our results suggest that screening scores developed in young population are not accurate in identifying CVI in older people.