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Fungal eye damages are rare but severe diseases that cause corneal opacity and blindness. The most common pathogens of such damages are Fusarium and Aspergillus. Fusarium is ubiquitous mold found commonly in soil and organic debris. The risk factors for fungal eye damages are trauma (plants, soil, metallic or foreign bodies), corneal surgery (keratoplasty), disruption of corneal epithelium, contact lens wear, and immunosuppressed patients. Clinical suspicion of fungal keratitis is helpful because the diagnosis is difficult to reach based on a laboratory verification, with corneal scraping in adequate culture medium and PCR. Fusarium sp are generally resistant to most antifungal drugs. Despite medical therapy with topical natamycin and voriconazole, surgery is often required with antifungal intracorneal injection, corneal transplantation, and enucleation. A 37-year-old patient presented with a trauma of cornea with a metallic piece was examined in this study. Nine months after local treatment, he complained of painful ocular lesion with a hypopyon. He was treated by intravitreal injection of vancomycin. A corneal scrapping showed hyphae of Fusarium proliferatum. He was treated with amphotericin B and voriconazole; however, no convincing efficacy was achieved and the unbearable eye pain persisted and, unfortunately, he was diagnosed with hepatic cytolysis. Due to the treatment failure, therefore, the enucleation was required and the pathological examination of the eye was found negative.

Some parasites, such as Trichomonas vaginalis or Sarcoptes scabiei, are sexually transmitted. However, sexual transmission of most intestinal parasites is very rare. The present study reports a case of homosexual man infected with HIV who was found to be a carrier of Strongyloides stercoralis, even though he had never traveled to the tropics. However, he had repeated sexual relations with many partners, some of whom were from endemic areas. Sexual transmission of Strongyloides stercoralis and amoebiasis due to Entamoeba histolytica is rare but has already been found in the population at risk. Therefore, this parasitosis should be sought in HIV patients complaining of digestive disorders.

Female genital schistosomiasis (FGS) is frequent in sub-Saharian Africa, Madagascar, and the Middle East, with localization in all organs of the reproductive tract, which causes many problems. However, vulvar localization of this disease is uncommon. The patient was a young woman of 25 years old with a complaint of a mass in the right labia minora. After the tumor removal, pathology examination revealed inflammatory granuloma with eggs of Schistosoma haematobium. The patient has never travelled to an endemic tropical area but has bathed in a contaminated river in Corsica, an island located in the south of France. The diagnosis of vulvar schistosomiasis can only be confirmed by biopsy of the lesion.

Resume La leptospirose, zoonose la plus frequente dans le monde, a l’incidence la plus elevee des departements et regions d’outre-mer a Mayotte. Un Comorien de 32 ans immigre a Mayotte se presente pour fievre et myalgies depuis huit jours. Les examens mettent en evidence une leptospirose, rapidement resolutive sous doxycycline. L’incidence en 2017 est de 66,3 cas pour 100 000 habitants, soit 170 cas declares. L’activite agricole et les co-expositions a la maladie (vie rurale, habitat degrade, divers animaux et rats dans l’environnement, accumulation de dechets dans les rues) sont des facteurs majeurs de risque de contamination a Mayotte. Une amelioration de l’hygiene generale est indispensable pour diminuer l’incidence de cette infection.

Background Imported loiasis is a rare cause of consultation at the return of stay in central Africa, which often poses difficult diagnostic and therapeutic questions to practitioners especially those who are unaccustomed to tropical medicine. These difficulties can lead to risks for the patients especially if inappropriate treatment is given. Large series of imported loiasis are scarce. Methods We retrospectively studied the data including outcome in patients diagnosed with imported loiasis between 1993 and 2013 in the Paris area on the basis of a parasitological diagnosis (microfilaremia > 1/ml and/or serologic tests). We compared sub-Saharan and non sub-Saharan African patients. Results Of the 177 identified cases, 167 could be analysed. Sex ratio was 1, mean age 41 years and 83% were sub-Saharan Africans. Cameroon was the main country of exposure (62%). Incubation time may be long (up to 18 months). Of the 167 cases, 57% presented with characteristic symptoms (Calabar swellings, creeping dermatitis, eyeworm) whereas 43% were diagnosed fortuitously. Microfilaremia was evidenced in 105 patients (63%), and specific antibodies in 53%. Compared to sub-Saharan Africans, other patients were presenting less frequently with eyeworm migration and microfilaremia whereas they had higher eosinophilia and positive serology. Prevalence of Calabar swellings was not significantly different between the two groups. Cure rates were 52% with ivermectin alone, and 77% with ivermectin followed by diethylcarbamazine. No severe adverse event was reported. Conclusions Presentation of imported loiasis varies according to ethnicity. A systematic screening should be recommended in patients with potential exposure in endemic country. Treatment with ivermectin followed by diethylcarbamazine could be a valuable option.

Resume Une famille revenue d'un voyage au Salvador a presente des troubles digestifs (douleurs abdominales, diarrhees). L'examen parasitologique des selles a revele la presence d'oocystes de Cyclospora cayetanensis, qui ont disparu sous trimethoprime-sulfamethoxazole. Ce parasiter est un protozoaire, de l'ordre des coccidies, connu chez l'homme depuis 1877. Il est cosmopolite mais plus frequent en zone tropicale, avec une prevalence de 2 a 11% selon les pays. L'infestation, due a l'ingestion des parasites avec l'eau et les crudites contaminees, provoque des troubles digestifs varies, plus importants chez le sujet immunodeprime (amaigrissement, deshydratation). Le diagnostic est base sur l'examen parasitologique des selles. Le traitement par trimethoprime--sulfamethoxazole est efficace. La prophylaxie necessite le respect des regles de l'hygiene alimentaire.

La Presse Medicale - In Press.Proof corrected by the author Available online since samedi 9 mars 2019

Eponyms are used almost daily in the clinical practice of dermatology. And yet, information about the person behind the eponyms is difficult to find. Indeed, who is? What is this person’s nationality? Is this person alive or dead? How can one find the paper in which this person first described the disease? Eponyms are used to describe not only disease, but also clinical signs, surgical procedures, staining techniques, pharmacological formulations, and even pieces of equipment. In this article we present the symptoms starting with (R) and other. The symptoms and their synonyms, and those who have described this symptom or phenomenon.

Resume Un cas de granulome inflammatoire contenant des oxyures a ete decouvert fortuitement lors d’une biopsie pour carcinome differencie de la vulve.

Resume Les zoonoses parasitaires sont cosmopolites et representent un important probleme pour les populations habitant dans le grand nord, ou la prevalence de certains parasites est plus elevee que dans le reste du continent nord Americain. Giardia intestinalis est tres repandu dans les regions du grand nord et des kystes de Giardia ont ete retrouves chez les animaux domestiques et sauvages, comme les castors et les phoques. La prevalence de Cryptosporidium est relativement faible dans ces contrees froides. Des serodiagnostics positifs de toxoplasmose ont ete deceles chez les animaux et les populations locales. Des cas humains et animaux de trichinellose ont ete signales dans ces regions polaires, suite a l’ingestion de viande mal cuite d’ours ou de phoque. D’autres nematodoses (Anisakis, Toxocara) ont ete repertoriees dans le grand nord, ainsi que differentes especes de Diphyllobothrium. Echinococcus canadensis est retrouve chez les canides et les cervides (caribous, rennes) au Canada et en Alaska, mais pas au Groenland. Les hotes definitifs de Echinococcus multilocularis sont les renards polaires, les renards roux et les chiens. En raison de l’education sanitaire et de la surveillance epidemiologique, aucun cas humain n’a ete signale en Alaska depuis 1986. Le rechauffement climatique va provoquer des perturbations ecologiques terrestres, fluviales et maritimes en facilitant la survie et la multiplication des parasites et donc leur dissemination parmi les animaux, les populations locales et les visiteurs.

Resume La balantidiose, zoonose parasitaire due a un protozoaire cilie, est cosmopolite, mais se rencontre surtout dans les pays tropicaux et subtropicaux. Elle se transmet a l’homme par ingestion d’eau ou d’aliments souilles contenant des kystes provenant des excrements des porcs. Comme les animaux, le sujet infeste reste le plus souvent porteur asymptomatique. Dans le cas contraire, les troubles cliniques peuvent preter a confusion avec une amoebose intestinale. Les complications graves sont rares mais parfois mortelles. Le diagnostic biologique est facile par l’examen parasitologique des selles. Le traitement, a base de tetracyclines ou de nitro-imidazoles, est tres efficace.

Resume L’orf est une zoonose cosmopolite due a un parapoxvirus ayant un tropisme pour les cellules epidermiques. L’infection, ou ecthyma contagiosum est endemique dans de nombreux troupeaux de moutons et de chevres. Les lesions des animaux sont surtout localisees sur le museau. La transmission a l’homme s’effectue par contact direct avec un animal infecte. La lesion evolue en plusieurs phases (macule, papule, nodule puis croute) avant de guerir spontanement en 4 a 6 semaines. L’examen histologique montre un infiltrat inflammatoire et des inclusions eosinophiliques dans les cellules epitheliales. L’infection par le parapoxvirus est confirmee par RT-PCR. Il n’y a pas de traitement specifique. La prevention est basee sur l’hygiene de l’elevage des animaux.

For administration of multiple live attenuated vaccines, the Advisory Committee on Immunization Practices recommends either simultaneous immunization or period of at least 28 days between vaccines, due to a possible reduction in the immune response to either vaccine. The main objective of this study was to compare the immune response to measles (alone or combined with mumps and rubella) and yellow fever vaccines among infants aged 6–24 months living in a yellow fever non-endemic country who had received measles and yellow fever vaccines before travelling to a yellow fever endemic area. Subjects and methods: A retrospective, multicenter case-control study was carried out in 7 travel clinics in the Paris area from February 1st 2011 to march 31, 2015. Cases were defined as infants immunized with the yellow fever vaccine and with the measles vaccine, either alone or in combination with mumps and rubella vaccine, with a period of 1–27 days between each immunization. For each case, two controls were matched based on sex and age: a first control group (control 1) was defined as infants having received the measles vaccine and the yellow fever vaccine simultaneously; a second control group (control 2) was defined as infants who had a period of more than 27 days between receiving the measles vaccine and yellow fever vaccine. The primary endpoint of the study was the percentage of infants with protective immunity against yellow fever, measured by the titer of neutralizing antibodies in a venous blood sample. Results: One hundred and thirty-one infants were included in the study (62 cases, 50 infants in control 1 and 19 infants in control 2). Of these, 127 (96%) were shown to have a protective titer of yellow fever antibodies. All 4 infants without a protective titer of yellow fever antibodies were part of control group 1. Discussion: The measles vaccine, alone or combined with mumps and rubella vaccines, appears to have no influence on humoral immune response to the yellow fever vaccine when administered between 1 and 27 days. The absence of protective antibodies against yellow fever was observed only among infants who received both vaccines simultaneously. Conclusion: These results may support a revision of current vaccination recommendations concerning the administration of these two live attenuated vaccines either on the same day or at least 28 days apart. Our findings show no statistically significant difference if the interval between both vaccines is more than 24 h, but the immune response seems to be reduced when the two vaccines are given at the same time.

Eponyms are used almost daily in the clinical practice of dermatology. And yet, information about the person behind the eponyms is difficult to find. Indeed, who is? What is this person’s nationality? Is this person alive or dead? How can one find the paper in which this person first described the disease? Eponyms are used to describe not only disease, but also clinical signs, surgical procedures, staining techniques, pharmacological formulations, and even pieces of equipment. In this article we present the symptoms starting with (M) and other. The symptoms and their synonyms, and those who have described this symptom or phenomenon.

Resume La consommation de poissons de mer, insuffisamment cuits ou crus peut etre a l’origine d’une anisakidose (ou anisakiose) par ingestion d’une larve de nematode de la famille des Anisakidae . Les poissons les plus parasites sont le hareng, le colin, le lieu noir et la morue. Dans la forme aigue, apparaissent des douleurs gastriques dans les heures suivant le repas contaminant. Ces douleurs, dues a la penetration de la muqueuse par une ou plusieurs larves, peuvent s’accompagner de manifestations allergiques. Les larves peuvent alors etre extirpees lors d’une endoscopie a visee diagnostique et therapeutique. La forme intestinale, tardive, est le plus souvent de decouverte fortuite, post-operatoire ; par la mise en evidence anatomo-pathologique de larves au sein d’un granulome responsable d’un syndrome tumoral du grele (douleur, occlusion, saignement). La forme chronique s’observe chez les patients sensibilises, consommateurs reguliers de poissons parasites, meme cuits. Elle est due a un allergene d’ A. simplex thermostable pouvant etre a l’origine d’urticaire chronique, d’angiœdeme et aussi de choc anaphylactique. Differents mecanismes immunitaires impliquant l’expression de cytokines induite par la presence du parasite (production d’IgE) associes a des predispositions genetiques ont pu etre identifies. Ces formes chroniques sont frequemment rapportees en Espagne, ou les consommateurs de poisson sont nombreux. Les tests biologiques sont parfois d’interpretation difficile du fait de la parente antigenique entre deux nematodes de la meme famille ( Ascaridoidea ) : A. simplex et Toxocara canis . Le meilleur element diagnostique et therapeutique de cette nouvelle forme d’anisakidose est l’arret de la consommation de poisson parasite qui permet la disparition des manifestations cliniques, en particulier de l’urticaire.

Resume La trichinellose est une zoonose parasitaire cosmopolite due a l’ingestion de viande de porc, de sanglier, de cheval ou encore d’ours. Elle se manifeste par une association de symptomes : fievre, diarrhees, œdeme de la face et myalgies. Le diagnostic est suspecte sur une elevation importante des eosinophiles sanguins et des enzymes musculaires, puis confirme par la serologie. Plus le traitement par albendazole et corticoides est precoce, plus il est efficace. La prophylaxie est basee sur le controle des viandes et la cuisson a cœur des viandes.

La Presse Medicale - In Press.Proof corrected by the author Available online since mercredi 27 fevrier 2013