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See detailExuberant inflammatory reaction as a side effect of platelet-rich plasma injection in treating one case of tendinopathy
Kaux, Jean-François ULg; Croisier, Jean-Louis ULg; LEONARD, Philippe ULg et al

in Clinical Journal of Sport Medicine (2014), 24(2), 150-152

Platelet-rich plasma (PRP) contains a large quantity of growth factors, which may enhance tendon healing processes. Local infiltration of PRP represents a relatively new treatment for tendinopathies. To ... [more ▼]

Platelet-rich plasma (PRP) contains a large quantity of growth factors, which may enhance tendon healing processes. Local infiltration of PRP represents a relatively new treatment for tendinopathies. To date, no side effects have been reported after infiltration of PRP to treat tendinopathy. We reported a case of exuberant inflammatory reaction after one infiltration of PRP to treat jumper’s knee in a type 1 diabetic patient who was 35 years old. Injections of PRP must be proposed after careful consideration for patients with morbidity risks linked to insulin-dependent diabetes. [less ▲]

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See detailA case of hemolytic anemia after severe malaria successfully treated with artesunate
ROUYA, Laura ULg; LEONARD, Philippe ULg; Hayette, Marie-Pierre ULg

Poster (2013, October 24)

Intravenous artesunate is the treatment of choice for severe and complicated malaria according to the WHO 2010 guidelines. Seventeencases of delayed hemolysis after parenteral treatment with artesunate ... [more ▼]

Intravenous artesunate is the treatment of choice for severe and complicated malaria according to the WHO 2010 guidelines. Seventeencases of delayed hemolysis after parenteral treatment with artesunate have been recently reported in European travellers with imported Plasmodium falciparummalaria1. We report the case of a 40-years-old Belgian man who contracted severe falciparum malaria after a four-weeks stay in Central and Eastern Africa without taking any antimalarial chemoprophylaxis. He presented on admission with fever, headache, jaundice andabdominal syndrome.Thereafter hisbiological and clinical conditionrapidly worsened withconsciousness disorders, severe thrombocytopenia,acute hepatitis and pancreatitis, and renal failure. Parasitemia reached a peak of 37 % on the second day of admission. Since this patient fulfilled WHO 2010 criteria for severe malaria,intravenous artesunatetreatment dosed at 2,4 mg/kg was started. Parasite clearancewas obtained after 48 hours and the patient’s clinical status improved significantly.Five doses of intravenous artesunate were administered, followed by oral artemeter/lumefantrine treatment during 60 hours. Tendays after the first dose of artesunate the patient developed a severe hemolyticanemia(hemoglobin4,9 g/dL) associated with impaired renal function. Thick blood film was negative. Blood transfusion and high doses of corticosteroids were successfully administrated and hemodialysis was not necessary. Until now, no clear explanation has been given to this complication. This case highlights the usefulness of extended follow-up including haematological parametersforpatients treated with artesunate, at least one monthafter the malaria episode. 1Published reports of delayed hemolyticanemia after treatment with artesunate for severe malaria--worldwide, 2010-2012. Centers for Disease Control and Prevention (CDC). [less ▲]

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See detailRéaction inflammatoire exubérante comme effet secondaire d’une infiltration de PRP
Kaux, Jean-François ULg; Croisier, Jean-Louis ULg; LEONARD, Philippe ULg et al

in Annals of Physical and Rehabilitation Medicine (2013, October), 56(Sup 1), 068

Introduction : Infiltrations of plasma rich platelets (PRP) represent a new treatment of tendinopathies. Currently, no side effects were reported in this indication. Case report: We report the case of a ... [more ▼]

Introduction : Infiltrations of plasma rich platelets (PRP) represent a new treatment of tendinopathies. Currently, no side effects were reported in this indication. Case report: We report the case of a 35-year-old type 1 diabetic patient with right upper patellar tendinopathy that had persisted for more than 6 months. The patient benefited from an intratendinous infiltration of 6 mL of PRP (8.105 platelets/mm3, almost no red or white blood cells) after a carefully disinfection but without local anesthesia. Typically, a standardized program of sub-maximal eccentric rehabilitation should be started 1 week after infiltration. However, the patient experienced local swelling with erythema, increased heating and pain, which appeared just underneath the patella, without biological inflammatory syndrome. In absence of septic general symptoms, no blood or wound culture were made. At 2 weeks post-infiltration, a greatly increased Doppler signal in a thicker tendon was observed by ultrasounds compared to that before infiltration, but there was no sign of infection demonstrated by either MRI or CT. However, the local inflammation did not decrease after a 3-week treatment of local cryotherapy, local and oral NSAID, and adjunct use of colchicine 1 mg. Thus, an insidious infection was suspected, even though there was no evidence of biological inflammatory syndrome or sign of infectious lesion on imagery examination. Antibiotic therapy (rifampicine 600 mg + minocycline 100 mg), was initiated for three months. Due to a lack of improvement via imaging and clinical examination, a 3-phase bone scintigraphy was performed. The results suggested the presence of a complex regional pain syndrome type 1. The patient benefited from classical physical therapy and concomitant pain killers. The evolution was favorable after 6 months of treatment. Discussion : Even though PRP infiltration represents a new and promising treatment for tendinopathy, more studies are needed both to verify its clinical efficacy. Moreover, implementing this innovative treatment requires caution because of potential adverse events. Thus, the balance between benefits and risks must be carefully evaluated before using this treatment, especially in patients with type 1 diabetes. [less ▲]

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See detailRéaction inflammatoire exubérante suite à une infiltration de PRP
Kaux, Jean-François ULg; Croisier, Jean-Louis ULg; LEONARD, Philippe ULg et al

in European Journal of Sports Medicine (2013, September), 1(Supplement 1), 278-279

Background: PRP, obtained from centrifuged autologous blood, contains a large quantity of growth factors, which may enhance the tissue healing processes. Local infiltration of PRP represents a relatively ... [more ▼]

Background: PRP, obtained from centrifuged autologous blood, contains a large quantity of growth factors, which may enhance the tissue healing processes. Local infiltration of PRP represents a relatively new treatment for tendinopathies. To date, no side effects have been reported after infiltration of PRP to treat tendinopathy. Case report: A 35-year-old patient had a right upper patellar tendinopathy which was resistant to all conservative treatments for more than 6 months. The patient was a type 1 diabetic (well controlled). He had an intratendinous infiltration of 6 mL of PRP (8.105 platelets/mm3, almost no red or white blood cells) after disinfection but without local anaesthetic. Immediately following the infiltration, local cryotherapy was performed for 15 minutes. NSAIDs were avoided, but class-1 or -2 pain-killers were authorised if necessary. A standardised sub-maximal eccentric rehabilitation should have been started 1 week after. However, the patient experienced local swelling with erythema, increased heating and pain which appeared just underneath the patella, but without biological inflammatory syndrome. A great Doppler signal in a thicker patellar tendon was observed by US, but there was no sign of local infectious disease demonstrated by either CT or MRI. However, the local inflammation did not decrease after a progressive 3-week treatment of local cryotherapy, local and oral NSAIDs and colchicine 1 mg. Thus, an insidious infection was suspected, even though there was neither evidence of biological inflammatory syndrome nor sign of infectious lesion on imagery examination. An antibiotic therapy (rifampicine 600 mg + minocycline 100 mg) was initiated for 3 months. Finally, a 3-phase bone scintigraphy suggested the presence of a complex regional pain syndrome type 1 treated by a classical physical therapy and concomitant class-2 pain killers. The evolution was favourable after 6 months of symptomatic treatment, and the pain decreased to a level similar to that before the infiltration of PRP. Discussion/Conclusions: This case report draws attention to potential side effects that are linked to this new therapy by infiltration of platelet rich plasma in case of tendinopathy, in particular when used in patients with type 1 diabetes. Thus, the balance between benefits and risks must be carefully evaluated before using this treatment in patients with type 1 diabetes. [less ▲]

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See detailExuberant inflammatory reaction after an infiltration of platelet-rich plasma to treat tendinopathy
Kaux, Jean-François ULg; Croisier, Jean-Louis ULg; LEONARD, Philippe ULg et al

in Book of abstracts of 18th Annual Congress of the ECSS (2013, June)

Background: PRP, obtained from centrifuged autologous blood, contains a large quantity of growth factors, which may enhance the tissue healing processes. Local infiltration of PRP represents a relatively ... [more ▼]

Background: PRP, obtained from centrifuged autologous blood, contains a large quantity of growth factors, which may enhance the tissue healing processes. Local infiltration of PRP represents a relatively new treatment for tendinopathies. To date, no side effects have been reported after infiltration of PRP to treat tendinopathy. Case report: A 35-year-old patient had a right upper patellar tendinopathy which was resistant to all conservative treatments for more than 6 months. The patient was a type 1 diabetic (well controlled). He had an intratendinous infiltration of 6 mL of PRP (8.105 platelets/mm3, almost no red or white blood cells) after disinfection but without local anaesthetic. Immediately following the infiltration, local cryotherapy was performed for 15 minutes. NSAIDs were avoided, but class-1 or -2 pain-killers were authorised if necessary. A standardised sub-maximal eccentric rehabilitation should have been started 1 week after. However, the patient experienced local swelling with erythema, increased heating and pain which appeared just underneath the patella, but without biological inflammatory syndrome. A great Doppler signal in a thicker patellar tendon was observed by US, but there was no sign of local infectious disease demonstrated by either CT or MRI. However, the local inflammation did not decrease after a progressive 3-week treatment of local cryotherapy, local and oral NSAIDs and colchicine 1 mg. Thus, an insidious infection was suspected, even though there was neither evidence of biological inflammatory syndrome nor sign of infectious lesion on imagery examination. An antibiotic therapy (rifampicine 600 mg + minocycline 100 mg) was initiated for 3 months. Finally, a 3-phase bone scintigraphy suggested the presence of a complex regional pain syndrome type 1 treated by a classical physical therapy and concomitant class-2 pain killers. The evolution was favourable after 6 months of symptomatic treatment, and the pain decreased to a level similar to that before the infiltration of PRP. Discussion/Conclusions: This case report draws attention to potential side effects that are linked to this new therapy by infiltration of platelet rich plasma in case of tendinopathy, in particular when used in patients with type 1 diabetes. Thus, the balance between benefits and risks must be carefully evaluated before using this treatment in patients with type 1 diabetes. Reference: Platelet-rich plasma application in the management of chronic tendinopathies. Acta Orthop Belg 2013; 79: 10-15. [less ▲]

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See detailExuberant inflammatory reaction after an infiltration of platelet-rich plasma (PRP)
Kaux, Jean-François ULg; Croisier, Jean-Louis ULg; LEONARD, Philippe ULg et al

in British Journal of Sports Medicine (2013, June), 47(10 (e3)), 92

Background: PRP, obtained from centrifuged autologous blood, contains a large quantity of growth factors, which may enhance the tissue healing processes. Local infiltration of PRP represents a relatively ... [more ▼]

Background: PRP, obtained from centrifuged autologous blood, contains a large quantity of growth factors, which may enhance the tissue healing processes. Local infiltration of PRP represents a relatively new treatment for tendinopathies. To date, no side effects have been reported after infiltration of PRP to treat tendinopathy. Case report: A 35-year-old patient had a right upper patellar tendinopathy which was resistant to all conservative treatments for more than 6 months. The patient was a type 1 diabetic (well controlled). He had an intratendinous infiltration of 6 mL of PRP (8.105 platelets/mm3, almost no red or white blood cells) after disinfection but without local anaesthetic. Immediately following the infiltration, local cryotherapy was performed for 15 minutes. NSAIDs were avoided, but class-1 or -2 pain-killers were authorised if necessary. A standardised sub-maximal eccentric rehabilitation should have been started 1 week after. However, the patient experienced local swelling with erythema, increased heating and pain which appeared just underneath the patella, but without biological inflammatory syndrome. A great Doppler signal in a thicker patellar tendon was observed by US, but there was no sign of local infectious disease demonstrated by either CT or MRI. However, the local inflammation did not decrease after a progressive 3-week treatment of local cryotherapy, local and oral NSAIDs and colchicine 1 mg. Thus, an insidious infection was suspected, even though there was neither evidence of biological inflammatory syndrome nor sign of infectious lesion on imagery examination. An antibiotic therapy (rifampicine 600 mg + minocycline 100 mg) was initiated for 3 months. Finally, a 3-phase bone scintigraphy suggested the presence of a complex regional pain syndrome type 1 treated by a classical physical therapy and concomitant class-2 pain killers. The evolution was favourable after 6 months of symptomatic treatment, and the pain decreased to a level similar to that before the infiltration of PRP. Discussion/Conclusions: This case report draws attention to potential side effects that are linked to this new therapy by infiltration of platelet rich plasma in case of tendinopathy, in particular when used in patients with type 1 diabetes. Thus, the balance between benefits and risks must be carefully evaluated before using this treatment in patients with type 1 diabetes. Reference: Platelet-rich plasma application in the management of chronic tendinopathies. Acta Orthop Belg 2013; 79: 10-15. [less ▲]

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See detailAbcès hépatique amibien contracté en Inde avec confirmation du diagnostic par PCR
Ho, Giang; Arenas Sanchez, Maria Mara ULg; LEONARD, Philippe ULg et al

in Revue Médicale de Liège (2013), 68(7-8), 428-432

Amoebiasis is a disease of parasitic origin responsible for dysentery and extraintestinal complications. It is due to the infection by Entamoebe histolytica an amoeba whose geographical distribution is ... [more ▼]

Amoebiasis is a disease of parasitic origin responsible for dysentery and extraintestinal complications. It is due to the infection by Entamoebe histolytica an amoeba whose geographical distribution is cosmopolitan but that is more prevalent in tropical areas. Only a few infections are symptomatic and some of them may cause extraintestinal complications. Hepatic amoebiasis is the most frequently observed. We report the case of a Belgian woman who developed amoebic liver abscess after returning from a trip to India. The diagnosis was confirmed by PCR detection of E. histolytica DNA performed on the abscess fluid. The epidemiological, diagnosis and treatment aspects are discussed. [less ▲]

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See detailProcalcitonin usefulness for the initiation of antibiotic treatment in intensive care unit patients.
LAYIOS, Nathalie ULg; LAMBERMONT, Bernard ULg; CANIVET, Jean-Luc ULg et al

in Critical Care Medicine (2012), 40(8), 2304-9

OBJECTIVES: : To test the usefulness of procalcitonin serum level for the reduction of antibiotic consumption in intensive care unit patients. DESIGN: : Single-center, prospective, randomized controlled ... [more ▼]

OBJECTIVES: : To test the usefulness of procalcitonin serum level for the reduction of antibiotic consumption in intensive care unit patients. DESIGN: : Single-center, prospective, randomized controlled study. SETTING: : Five intensive care units from a tertiary teaching hospital. PATIENTS: : All consecutive adult patients hospitalized for > 48 hrs in the intensive care unit during a 9-month period. INTERVENTIONS: : Procalcitonin serum level was obtained for all consecutive patients suspected of developing infection either on admission or during intensive care unit stay. The use of antibiotics was more or less strongly discouraged or recommended according to the Muller classification. Patients were randomized into two groups: one using the procalcitonin results (procalcitonin group) and one being blinded to the procalcitonin results (control group). The primary end point was the reduction of antibiotic use expressed as a proportion of treatment days and of daily defined dose per 100 intensive care unit days using a procalcitonin-guided approach. Secondary end points included: a posteriori assessment of the accuracy of the infectious diagnosis when using procalcitonin in the intensive care unit and of the diagnostic concordance between the intensive care unit physician and the infectious-disease specialist. MEASUREMENTS AND MAIN RESULTS: : There were 258 patients in the procalcitonin group and 251 patients in the control group. A significantly higher amount of withheld treatment was observed in the procalcitonin group of patients classified by the intensive care unit clinicians as having possible infection. This, however, did not result in a reduction of antibiotic consumption. The treatment days represented 62.6 +/- 34.4% and 57.7 +/- 34.4% of the intensive care unit stays in the procalcitonin and control groups, respectively (p = .11). According to the infectious-disease specialist, 33.8% of the cases in which no infection was confirmed, had a procalcitonin value >1microg/L and 14.9% of the cases with confirmed infection had procalcitonin levels <0.25 microg/L. The ability of procalcitonin to differentiate between certain or probable infection and possible or no infection, upon initiation of antibiotic treatment was low, as confirmed by the receiving operating curve analysis (area under the curve = 0.69). Finally, procalcitonin did not help improve concordance between the diagnostic confidence of the infectious-disease specialist and the ICU physician. CONCLUSIONS: : Procalcitonin measuring for the initiation of antimicrobials did not appear to be helpful in a strategy aiming at decreasing the antibiotic consumption in intensive care unit patients. [less ▲]

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See detailA pauci-symptomatic case of documented Hantavirus (Puumala) infection in a patient under anti-TNF treatment.
Moutschen, Pierre; Bourhaba, Maryam ULg; FRIPPIAT, Frédéric ULg et al

in Journal of Clinical Virology (2011), 50(3), 247-8

We describe the case of an 18-yr-old male under anti-TNF treatment for Crohn's disease for more than 8 months. He developed fever and biological inflammatory syndrome without absolutely no accompanying ... [more ▼]

We describe the case of an 18-yr-old male under anti-TNF treatment for Crohn's disease for more than 8 months. He developed fever and biological inflammatory syndrome without absolutely no accompanying sign or symptom or paraclinical abnormality despite extensive work-up performed in the context of his immunocompromised state. Symptoms disappeared after 10 days and a diagnosis of Puumala infection was made retrospectively on a serological basis. The case illustrates that anti-TNF treatment does not worsen the course of Puumala infection and could even be associated with a milder clinical picture. [less ▲]

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See detailAutoimmune angioneurotic edema in a patient with Helicobacter pylori infection.
Mukeba, Didier; Chandrikakumari, Kavitha; Giot, Jean-Baptiste ULg et al

in Helicobacter (2009), 14(1), 9-11

Association of acquired autoimmune angioneurotic edema with other diseases is increasing. However, the precise mechanism by which antibodies to C1-esterase inhibitor (C1-INH) are produced, is not ... [more ▼]

Association of acquired autoimmune angioneurotic edema with other diseases is increasing. However, the precise mechanism by which antibodies to C1-esterase inhibitor (C1-INH) are produced, is not elucidated. We describe a patient with IgA antibodies against C1-INH without other autoimmune markers. Our patient had gastritis and Helicobacter pylori infection, proven by biopsy. This case suggests that H. pylori infection can act as triggering factor for acquired autoimmune angioneurotic edema. [less ▲]

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See detailLa neuroborréliose: quand la tique a piqué
Cuvelier, M.L.; LEONARD, Philippe ULg; RIKIR, Estelle ULg et al

in Revue Médicale de Liège (2008), 63(5-6), 349-353

L’infection à Borrelia burgdorferi est fréquente dans nos régions. Les complications neurologiques de cette infection se rencontrent essentiellement lors de la phase de dissémination précoce et à la phase ... [more ▼]

L’infection à Borrelia burgdorferi est fréquente dans nos régions. Les complications neurologiques de cette infection se rencontrent essentiellement lors de la phase de dissémination précoce et à la phase tardive de l’infection. La neuroborréliose se manifeste surtout par des radiculalgies rebelles au traitement, parfois associées à une neuropathie crânienne, en grande majorité faciale. L’évolution est satisfaisante sous antibiothérapie adaptée. Celle-ci reste nécessaire en dépit du fait que la plupart des complications de la neuroborréliose disparaissent spontanément. Le traitement permet d’éviter la survenue de complications tardives ou de voir apparaître des atteintes extraneurologiques éventuelles. [less ▲]

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See detailChronic hepatitis C infection in a patient with bone marrow hypoplasia.
Bethlen, S.; Chandrikakumari, Kavitha; de Leval, Laurence ULg et al

in World Journal of Gastroenterology (2008), 14(26), 4238-40

Chronic hepatitis C virus (HCV) infection is associated with multifarious extra-hepatic manifestations; the most described and discussed being mixed cryoglobulinemia which is strongly related to B-cell ... [more ▼]

Chronic hepatitis C virus (HCV) infection is associated with multifarious extra-hepatic manifestations; the most described and discussed being mixed cryoglobulinemia which is strongly related to B-cell lymphoproliferative disorders (LPDs). We present a case of chronic HCV infection and mixed cryoglobulinemia, with minimal liver involvement. The case is a 53-year-old patient who was diagnosed as having bone marrow hypoplasia at the age of three. She received several blood transfusions to normalize her haemoglobin. At the age of 31, she was diagnosed with rheumatoid arthritis on account of her diffuse joint pain and inflammation, elevated rheumatoid factor (RF) and Raynaud's phenomenon. Twenty years later, monoclonal gammopathy of IgG Lambda (one year later, changed to IgM Kappa) was detected during a routine examination. A bone marrow biopsy showed hypoplasia, Kappa positive B-lymphocytes and low-grade malignant lymphoma cells. PCR of the bone marrow aspirate was not contributory. No treatment was initiated owing to her poor bone marrow function and she is under regular follow-up. [less ▲]

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See detailSyphilis en 2008: controverses et attitudes pratiques.
Frippiat, Frédéric ULg; GIOT, Jean-Baptiste ULg; Chandrikakumari, Kavitha et al

in Revue Médicale Suisse (2008), 4(168), 1823-7

Rising incidence rate of syphilis is observed in economically advanced countries, particularly among homosexual men and subpopulation with low socioeconomic status. The various clinical presentations are ... [more ▼]

Rising incidence rate of syphilis is observed in economically advanced countries, particularly among homosexual men and subpopulation with low socioeconomic status. The various clinical presentations are divided into early and late stages, including neurosyphilis. The latter can occur during any stage of the disease, leading to the question "when to perform lumbar puncture", particularly in HIV positive patients. Penicillin continues to be the first-line therapy for all stages of syphilis. An alternative treatment should be considered as an exemption, after advice from a specialist. All patients require prolonged clinical and serological follow-up after treatment to rule out relapse or re-infection. The diagnosis of syphilis is an opportunity to search and treat other sexually transmitted diseases in patients and their sexual partner(s). [less ▲]

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See detailWhen HIV gets into the brain
Cuvelier, Marie-Laure ULg; Leonard, Philippe ULg; Rikir, Estelle ULg et al

in Revue Médicale de Liège (2008), 63(5-6), 338-341

Besides opportunistic infections, direct or indirect HIV-mediated lesions of cerebral vascular or neural cells can also occur during the natural course of HIV infection. The main non-infectious ... [more ▼]

Besides opportunistic infections, direct or indirect HIV-mediated lesions of cerebral vascular or neural cells can also occur during the natural course of HIV infection. The main non-infectious complications of HIV are cerebral lymphomas, cerebrovascular disorders, HIV dementia and myelitis. [less ▲]

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See detailHIV-related infections of the brain
Cuvelier, Marie-Laure ULg; Leonard, Philippe ULg; Rikir, Estelle ULg et al

in Revue Médicale de Liège (2008), 63(5-6), 342-348

During the natural course of human immunodeficiency virus infection, central nervous system insults are very common. They can consist of infectious complications, consequently to the collapse of the ... [more ▼]

During the natural course of human immunodeficiency virus infection, central nervous system insults are very common. They can consist of infectious complications, consequently to the collapse of the patient's immune system. Alternatively, direct or indirect HIV-mediated lesions of cerebral vascular or neural cells can also occur. It is crucial to detect HIV-related infectious complications since their prognosis will depend on early and accurate treatments. The diagnosis is generally made by means of magnetic resonance imaging and lumbar puncture. [less ▲]

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See detailReport of a case of Streptococcus agalactiae mycotic aneurysm and review of the literature.
Chandrikakumari, Kavitha; Giot, Jean-Baptiste ULg; de Leval, Laurence ULg et al

in International Journal of Surgical Pathology (2008), 16(3), 314-9

A unique case of mycotic aneurysm of the abdominal aorta caused by Streptococcus agalactiae in an afebrile patient presenting with abdominal pain is described. Although this bacterium is associated with a ... [more ▼]

A unique case of mycotic aneurysm of the abdominal aorta caused by Streptococcus agalactiae in an afebrile patient presenting with abdominal pain is described. Although this bacterium is associated with a variety of infections in human beings, aortitis is uncommon. Chronic alcoholism and diabetes mellitus are the 2 major predisposing conditions for group B Streptococci infection and both were present in this case. The abdominal pain and elevated inflammatory markers in the absence of fever were elusive in presentation; however, the diagnosis of mycotic aneurysm was established by abdominal computed tomography scan. The patient was treated successfully by resection of the diseased aorta and aortic allograft replacement. Culture of the excised tissue grew Streptococcus agalactiae sensitive to penicillin G and (other commonly tested antibiotics) fluoroquinolones. A prolonged course of moxifloxacin (for 6 months) was administered due to the persistence of elevated inflammatory markers and was remarkably well tolerated. Sixteen months after stopping the antibiotics, the patient is doing well, and the control imaging studies are satisfactory. [less ▲]

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See detailRecombinant gp350 vaccine for infectious mononucleosis: A phase 2, randomized, double-blind, placebo-controlled trial to evaluate the safety, immunogenicity, and efficacy of an Epstein-Barr virus vaccine in healthy young adults
Sokal, E. M.; Hoppenbrouwers, K.; Vandermeulen, C. et al

in Journal of Infectious Diseases (2007), 196(12), 1749-1753

Background. To date, there is no commercially available vaccine to prevent infectious mononucleosis, a disease frequently induced by Epstein-Barr virus (EBV) infection in adolescents or adults devoid of ... [more ▼]

Background. To date, there is no commercially available vaccine to prevent infectious mononucleosis, a disease frequently induced by Epstein-Barr virus (EBV) infection in adolescents or adults devoid of preexisting immunity to the virus. Methods. A total of 181 EBV-seronegative, healthy, young adult volunteers were randomized in a double-blind fashion to receive either placebo or a recombinant EBV subunit glycoprotein 350 (gp350)/aluminum hydroxide and 3-O-desacyl-4'-monophosphoryl lipid A (AS04) candidate vaccine in a 3-dose regimen. Results. The vaccine had demonstrable efficacy (mean efficacy rate, 78.0% [95% confidence interval {CI}, 1.0% -96.0%]) in preventing the development of infectious mononucleosis induced by EBV infection, but it had no efficacy in preventing asymptomatic EBV infection. One month after receipt of the final dose of gp350 vaccine, 98.7% of subjects showed seroconversion to anti-gp350 antibodies (95% CI, 85.5%-97.9%), and they remained anti-gp350 antibody positive for > 18 months. Furthermore, there were no concerns regarding the safety or reactogenicity of the gp350/AS04 vaccine. Conclusion. These data support the clinical feasibility of using an EBV vaccine to prevent infectious mononucleosis. [less ▲]

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See detailA Patient with Hiv Infection, Cough, Asthenia, and Fever
Mayasi, N.; Chandrikakumari, Kavitha; Mukeba, D. et al

in Clinical Infectious Diseases : An Official Publication of the Infectious Diseases Society of America (2007), 45(5), 662-3559-600

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See detailPhase I/II studies to evaluate safety and immunogenicity of a recombinant gp350 Epstein-Barr virus vaccine in healthy adults
Moutschen, Michel ULg; Leonard, Philippe ULg; Sokal, E. M. et al

in Vaccine (2007), 25(24), 4697-4705

Two double-blind randomised controlled studies (phase I and I/II) were performed to assess for the first time the safety and immunogenicity of a recombinant subunit gp350 Epstein-Barr virus (EBV) vaccine ... [more ▼]

Two double-blind randomised controlled studies (phase I and I/II) were performed to assess for the first time the safety and immunogenicity of a recombinant subunit gp350 Epstein-Barr virus (EBV) vaccine in 148 healthy adult volunteers. All candidate vaccine formulations had a good safety profile and were well tolerated, with the incidence of solicited and unsolicited symptoms within a clinically acceptable range. One serious adverse event was reported in the phase I trial which was considered to be of suspected relationship to vaccination. The gp350 vaccine formulations were immunogenic and induced gp350-specific antibody responses (including neutralising antibodies). (c) 2007 Elsevier Ltd. All rights reserved. [less ▲]

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