RESUMO
We report a case of spinal cord toxoplasmosis occurring as a primary infection in a 31-year-old immunocompetent man. Exhaustive immunologic and genetic investigations did not identify any immunodeficiency. The causative agent was a typical type 2 strain. In cases of spinal cord lesions, toxoplasmosis should be considered, even in an immunocompetent patient.
Assuntos
Carne/parasitologia , Repetições de Microssatélites/genética , Toxoplasma/genética , Toxoplasmose Cerebral/diagnóstico , Adulto , Animais , Genótipo , Humanos , Masculino , Sus scrofa/parasitologia , Toxoplasma/classificação , Toxoplasmose Cerebral/parasitologiaRESUMO
OBJECTIVES: Patients hospitalized for influenza should receive early treatment with a neuraminidase inhibitor. PATIENTS AND METHODS: We conducted a retrospective study of the prescription of oseltamivir during the 2016-2017 influenza epidemic among patients hospitalized for influenza confirmed by RT-PCR in the infectious disease department. RESULTS: Treatment with oseltamivir was initiated as recommended in 96% of hospitalized patients presenting with influenza. However, a delay in prescription was observed with only 18% of prescriptions made on the first day. The prescriptions were exclusively initiated in the infectious disease department. CONCLUSION: To improve the early prescription of oseltamivir during the influenza season, two recommendations are essential: oseltamivir availability in the emergency department pharmacy, awareness of physicians of the need to prescribe to any patient hospitalized for a lower respiratory tract infection treatment with a neuraminidase inhibitor upon admission to the emergency department.
Assuntos
Diagnóstico Tardio/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Influenza Humana/tratamento farmacológico , Oseltamivir/uso terapêutico , Tempo para o Tratamento/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Diagnóstico Precoce , Serviços Médicos de Emergência/estatística & dados numéricos , Epidemias , Feminino , França/epidemiologia , Hospitais/estatística & dados numéricos , Humanos , Influenza Humana/epidemiologia , Masculino , Pessoa de Meia-Idade , Técnicas de Diagnóstico Molecular , Prescrições/estatística & dados numéricos , Estudos Retrospectivos , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Tempo para o Tratamento/normasRESUMO
OBJECTIVE: Cerebrospinal fluid (CSF) leukocytes analysis is commonly used to diagnose meningitis and to differentiate bacterial from viral meningitis. Interpreting CSF monocytes can be difficult for physicians, especially in France where lymphocytes and monocytes results are sometimes pooled. PATIENTS AND METHODS: We assessed SF monocytes in patients presenting with microbiologically confirmed meningitis (CSF leukocyte count>10/mm3 for adults or >30/mm3 for children<2 months), i.e. bacterial meningitis (BM), viral meningitis (VM), and neuroborreliosis (NB). RESULTS: Two-hundred patients (82 BM, 86 VM, and 32 NB) were included. The proportions of monocytes were higher in VM (median 8%; range 0-57%) than in BM (median 5%; range 0-60%, P=0.03) or NB (median 5%; range 0-53%, P=0.46), with a high value overlap between conditions. CONCLUSION: CSF monocytes should not be used to discriminate BM from VM and NB because of value overlaps.