[The first French hemorrhagic fever with renal syndrome in pregnant woman]. / Premier cas de fièvre hémorragique avec syndrome rénal au cours de la grossesse en France.

The seroprevalence of hantavirus in France is very low. The hantavirus is the causative agent of hemorrhagic fever with renal syndrome (HFRS). In 2005, we report the first French HFRS case in a pregnant woman presenting with influenza like symptoms in an endemic area associated with suggestive biologic abnormalities. She was delivered by emergency cesarean section. Her child had a neonatal respiratory distress, thrombocytopenia and elevated liver enzymes levels, which suggest a transplacental hantavirus transmission.

Nephropathia epidemica and leptospirosis in Champagne-Ardenne, France: comparison of clinical, biological and epidemiological profiles.

In the present retrospective study, we described a series of 45 non-icteric leptospirosis and 44 nephropathia epidemica (NE) patients diagnosed in the northeast of France from 1995 to 2005 and compared their clinical picture and laboratory parameters, as well as some epidemiological data. Loin pain (P < 0.001), abdominal pains (P = 0.007), rise of blood pressure (P < 0.001) and pharyngitis (P = 0.01) were more frequently found in NE patients. Aspartate aminotransferase (ASAT) (P = 0,006), creatine phosphokinase (CPK) (P < 0.0001) and C-reactive protein (CRP) (P < 0.0001) were higher in leptospirosis, whereas creatinine (P = 0.009) was higher in NE. Leptospirosis mainly concerns occupational hazards, e.g. farmers, and leisure activities like swimming, and NE concerns professional foresters or leisure activities in the forest and the cleaning of attics. During hospitalisation, patients receiving antibiotics were more frequent among leptospirosis than among NE patients (80% versus 59%, P = 0.06). Among the various common clinical signs, only acute myopia appeared to be a pathognomonic but inconsistently observed clinical sign, which was only observed in 47% of NE cases.

[Value of a rapid screening technique for vaginal carriage of group B Streptococcus during hig-risk pregnancies]. / Intérêt d'une technique rapide de dépistage vaginal du portage de streptocoque du groupe B au cours des grossesses à risque.

Vaginal colonization by Group B streptococci (GBS) during pregnancy is associated with lige-threatening neonatal infections acquired during passage through the birth canal. Factors associated with an increased risk of GBS transmission to the neonate include prematurity, premature spontaneous rupture of the membranes before 37 weeks of gestational age, prolonged (> 12 h) rupture of the membranes at full term, fever in the mother, multiple pregnancy, and a history of GBS infection. A study was conducted to evaluate the performance characteristics of a rapid GBS screening test comparatively with conventional microbiological cultures. The 113 high-risk women admitted for delivery to the obstetrics department of the Charleville-Mézières Hospital from January to May 1998 were included in the study. Vaginal specimens were examined by both the Strep B OIA test (International Microbio) and by conventional culturing. Comparison of the results of these two methods showed that sensitivity and specificity of the Strep B OIA test were satisfactory. The Strep B OIA test is a rapid test suitable for use in emergency situations. A positive result should lead to intrapartum prophylactic antimicrobial therapy.