Pulmonary Toxoplasmosis, a Rare but Severe Manifestation of a Common Opportunistic Infection in Late HIV Presenters: Report of Two Cases

Abstract : Pulmonary toxoplasmosis is rare, particularly in the era of highly active antiretroviral therapy (HAART). Here, we describe two severe cases in patients not known to be HIV-infected. In both patients, early diagnosis and therapy led to a favourable outcome. Pulmonary toxoplasmosis should be considered in the differential diagnosis in potentially HIV-infected patients with respiratory symptom

Aerococcus urinae Endocarditis: Case Report and Review of the Literature

Aerococcus urinae is a rare cause of urinary tract infections, mainly in elderly men with underlying urinary tract pathologies. In addition, it has been described as a pathogen in balanitis, soft tissue infections, septicemia and endocarditis. To date ten cases of A. urinae endocarditis have been reported in the literature with a high rate of mortality (7/10) and morbidity, as two out of three survivors suffered from neurovascular complications. Here we present the case of an additional patient who was successfully treated with surgical valve replacement and antibiotic therapy consisting of ceftriaxone and netilmicin for 6 weeks. Furthermore, we review all reported cases of A. urinae endocarditis with emphasis on predisposing factors and therapeutic options

Delayed Diagnosis of a Diffuse Invasive Gastrointestinal Aspergillosis in an Immunocompetent Patient

Invasive aspergillosis represents a clinical picture frequently associated with host’s immunosuppression which usually involves a high morbidity and mortality. In general, the most frequent fungal entry is the lungs with secondary hematogenous dissemination, but there are other hypotheses like a gastrointestinal portal of entry. There are some rare publications of cases with invasive aspergillosis in immunocompetent patients. We present the case of an immunocompetent patient without any risk factors except for age, ICU stay, and surgical intervention, who developed a septic shock by invasive gastrointestinal aspergillosis as primary infection. Due to the unusualness of the case, despite all the measures taken, the results were obtained postmortem. We want to emphasize the need not to underestimate the possibility for an invasive aspergillosis in an immunocompetent patient. Not only pulmonary but also gastrointestinal aspergillosis should be taken into account in the differential diagnosis to avoid a delay of treatment

Pulmonary toxoplasmosis, a rare but severe manifestation of a common opportunistic infection in late HIV presenters: report of two cases

Pulmonary toxoplasmosis is rare, particularly in the era of highly active antiretroviral therapy (HAART). Here, we describe two severe cases in patients not known to be HIV-infected. In both patients, early diagnosis and therapy led to a favourable outcome. Pulmonary toxoplasmosis should be considered in the differential diagnosis in potentially HIV-infected patients with respiratory symptom

Rhinofacial Conidiobolus coronatus Infection Presenting with Nasal Enlargement

Rhinofacial Conidiobolus coronatus infection is a rare form of zygomycosis in humans living in the northern hemispheres. Most human cases are observed in the periequatorial areas of Africa, Asia, or South America. Only limited information regarding optimal treatment is available. We report a case of rhinofacial C. coronatus infection in an emigrated Sudanese patient. The infection was successfully treated with terbinafin and itraconazole for 12 months. Diagnosis was confirmed by microbiological culture from a tissue biopsy. Antimicrobial susceptibility testing of this organism was not predictive of optimal therapy

Chronologie et répartition spatiale des établissements fortifiés tardo-laténiens du Plateau et du Jura suisses

International audienceDer vorliegende Gemeinschaftsartikel diskutiert die spätlatènezeitliche Siedlungslandschaft im heutigen Schweizer Mittelland und Jura. Trotzteilweise lückenhaftem Forschungsstand können im Untersuchungsgebiet zwanzig befestigte Siedlungen lokalisiert und, dank einer aufReferenzfundkomplexen basierenden Regionalchronologie, datiert werden. Die Zeitstellung und Belegungsdauer der Siedlungen geben Einblickein die vorherrschende Siedlungsdynamik. Während sich im Umland Genfs und im Jura eine stabile Siedlungslandschaft abzeichnet, zeigt sich imMittelland am Übergang der Stufen LT D1b zu LT D2a bei der Art der befestigten Siedlungen ein grösserer Wechsel: Praktisch alle grossen befestigtenSiedlungen werden verlassen und es entstehen kleinere Neugründungen. Der Prozess setzt sich in der Stufe LT D2b fort mit der Entstehungneuer, stärker militärisch geprägter Siedlungen.Despite the sometimes incomplete nature of the archaeological record for the late Iron Age, it is still possible to date the twenty known fortifiedsites in the Swiss Plateau and Jura. The chronology is established from a corpus of settlements in these regions, which have been recentlyenriched with new find assemblages. Thanks to the site chronology, trajectories in their occupation can be identified. While a certain continuitycharacterizes the sites of Geneva and in the Jura, a rupture appears clearly in the sites in the Swiss Plateau at the time of transition from La TèneD1b and D2a, when almost all of the large fortified sites of the Plateau were abandoned in favour of smaller foundations. From La Tène D2bonwards, these were then complemented by new sites with an essentially military character (traduction Andrew Lawrence)

Clinical characteristics and outcome of patients over 60 years with Hodgkin lymphoma treated in Switzerland.

Hodgkin lymphoma (HL) in older patients appears to be a different disease compared with younger patients with historically lower survival rates. This is related to a variety of factors, including increased treatment-related toxicity, the presence of comorbidities, and biologic differences. In order to better assess the clinical characteristics, treatment strategies, and outcome of this particular population, we conducted a population-based, retrospective analysis including 269 patients with HL older than 60 years (median age 71 years, range 60-94), treated between 2000 and 2017 in 15 referral centers across Switzerland. Primary endpoints were overall survival (OS), progression-free survival (PFS), and cause-specific survival (CSS). The vast majority of patients were treated with curative intent, either with a combined modality approach (chemotherapy followed by radiation therapy) or with systemic therapy. At a median follow-up of 6.6 years (95% confidence interval [CI], 6.0-7.6), 5-year PFS was 52.2% (95% CI, 46.0-59.2), 5-year OS was 62.5% (95% CI, 56.4-69.2), and 5-year CSS was 85.1.8% (95% CI, 80.3-90.1) for the entire cohort. A significant difference in terms of CSS was observed for patients older than 71 years in comparison to patients aged 60-70 years (hazard ratio 2.6, 1.3-5.0, p = 0.005). Bleomycin-induced lung toxicity (BLT) was documented in 26 patients (17.7%) out of the 147 patients exposed to this compound and was more frequent in patients older than 71 years (15/60, 25%). Outcome of HL pts older than 71 years appeared to decrease substantially in comparison to the younger counterpart. Treatment-related toxicities appeared to be relevant, in particular, BLT. New, potentially less toxic strategies need to be investigated in prospective clinical trials in this particular frail population