[Overview of infectious and non-infectious diseases in French Guiana in 2022]. / Panorama des pathologies infectieuses et non infectieuses de Guyane en 2022.

Source of many myths, French Guiana represents an exceptional territory due to the richness of its biodiversity and the variety of its communities. The only European territory in Amazonia, surrounded by the Brazilian giant and the little-known Suriname, Ariane 6 rockets are launched from Kourou while 50% of the population lives below the poverty line. This paradoxical situation is a source of health problems specific to this territory, whether they be infectious diseases with unknown germs, intoxications or chronic pathologies.Some infectious diseases such as Q fever, toxoplasmosis, cryptococcosis or HIV infection are in common with temperate countries, but present specificities leading to sometimes different management and medical reasoning. In addition to these pathologies, many tropical diseases are present in an endemic and / or epidemic mode such as malaria, leishmaniasis, Chagas disease, histoplasmosis or dengue. Besides, Amazonian dermatology is extremely varied, ranging from rare but serious pathologies (Buruli ulcer, leprosy) to others which are frequent and benign such as agouti lice (mites of the family Trombiculidae) or papillonitis. Envenomations by wild fauna are not rare, and deserve an appropriate management of the incriminated taxon. Obstetrical, cardiovascular and metabolic cosmopolitan pathologies sometimes take on a particular dimension in French Guiana that must be taken into account in the management of patients. Finally, different types of intoxication are to be known by practitioners, especially due to heavy metals.European-level resources offer diagnostic and therapeutic possibilities that do not exist in the surrounding countries and regions, thus allowing the management of diseases that are not well known elsewhere.Thanks to these same European-level resources, research in Guyana occupies a key place within the Amazon region, despite a smaller population than in the surrounding countries. Thus, certain pathologies such as histoplasmosis of the immunocompromised patient, Amazonian toxoplasmosis or Q fever are hardly described in neighboring countries, probably due to under-diagnosis linked to more limited resources. French Guiana plays a leading role in the study of these diseases.The objective of this overview is to guide health care providers coming to or practicing in French Guiana in their daily practice, but also practitioners taking care of people returning from French Guiana.

[Multifocal tuberculosis associated with cerebral toxoplasmosis in an African immigrant immunocompromised patient due to HIV-infection at the Hospital Centre in Soissons, France]. / Tuberculose multifocale associée à une toxoplasmose cérébrale sur terrain immunodéprimé à VIH chez un patient immigré africain au Centre Hospitalier de Soissons, France.

In the industrialized countries and, in particular, in France, given the means of prevention, early screening and treatment of HIV infection, there is almost no evidence of opportunistic infections among immigrants and in some disadvantaged socio-professional groups. We here report the case of a 42-year old African immigrant HIV1 positive man with impaired general condition hospitalized for infectious syndrome. He had received antiretroviral therapy for 2 years and stopped it four months before admission. He had had pulmonary tuberculosis treated and declared cured in February 2017. Clinical examination showed slow ideation, a temperature of 39.6°C and weight loss. The patient had nadir CD4 cell counts 12/mm3 and HIV viral load log value 5.80. Thoracoabdominal CT scan and brain MRI showed intra-abdominal and thoracic lesions as well as brain lesions before diagnostic confirmation of tuberculosis and toxoplasmosis. The patient underwent triple antiretroviral therapy on day 15 of antituberculosis treatment. Then he underwent toxoplasmosis treatment with favorable outcome.