Case series of four re-infections with a SARS-CoV-2 B.1.351 variant, Luxembourg, February 2021.

We describe four SARS-CoV-2 re-infections with a B.1.351 variant in 2021, in healthcare workers (HCWs) previously infected in 2020, before detection of this variant in Europe. Cases live in France, near the border with Luxembourg, where variants B.1.351 and B.1.1.7 circulated. All work in the same hospital unit where a cluster of COVID 19 with B1.351 variant occurred, affecting patients and HCWs. Before the cluster onset, HCWs used surgical masks, as per recommendations. After cluster onset, HCWs used FFP2 masks.

Staphylococcus aureus Bloodstream Infection in Patients With Prosthetic Joints in the Prospective VIRSTA Cohort Study: Frequency and Time of Occurrence of Periprosthetic Joint Infection.

Among 143 patients of the VIRSTA cohort study with Staphylococcus aureus bacteremia and an arthroplasty implanted for more than a year, S. aureus periprosthetic joint infection was observed in 19%. Signs of infection (pain and swelling) were always present, in median 1 day (range, 0-21 days) after onset of bacteremia. Staphylococcus aureus has both a high potential for metastatic infection and a high affinity for foreign material. Possible prosthesis infection is of clinical concern in all patients with preexisting prosthetic materials experiencing S. aureus bloodstream infection (SAB). Prosthetic joints are especially prone to infection during the course of bacteremia, with a risk of infection much higher with S. aureus than with other microorganisms, 20% vs 7%, in a recent prospective study [1]. As early intervention with debridement in prosthetic joint infection (PJI) is paramount to retain the implant and to prevent infection relapse; eliminating PJI after SAB is important. However, additional data are needed to better describe the clinical characteristics of PJI after SAB in particular time lapses and whether systematic imaging of the prosthesis could be necessary after SAB. We described the frequency and clinical presentation of PJIs observed among patients with prosthetic joints implanted for >1 year before bacteremia and enrolled in the VIRSTA study, a multicenter prospective cohort study of patients with SAB.

Unusual seminoma revealed by bone metastasis.

We report a first case of primitive mediastinal seminoma revealed by bone metastasis without testicular tumor. In a 24-year-old patient with a 6-month history of isolated right hip pain, having normal X-ray and blood tests, we discovered a clinically silent chest mass being diagnosed as seminoma on needle biopsy. Etoposide-ifosfamide-cisplatin chemotherapy was chosen because of the presence of multiple lesions and its lesser toxicity. Germ cell tumors are a rare cause of bone metastases and need to be known to rheumatologists because of their excellent prognosis when recognized and treated early. We discuss new diagnostic (CT, MRI and PET-Scan) and treatment (chemotherapy and radiotherapy) strategies applied to our patient.