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Les anévrismes infectieux de l'axe fémoro-poplité sont rares et d'évolution silencieuse. Ils surviennent surtout chez les sujets immunodéprimés. Leur traitement fait appel souvent à l'exclusion chirurgicale associée ou non à un geste de revascularisation. Nous rapportons le cas d'un patient opéré pour un anévrisme de l'artère fémorale superficielle, lié à une infection à salmonelle, il a eu une résection de l'anévrysme et une revascularisation par greffe veineuse. Ce patient a été repris par la suite à deux reprise pour rupture du greffon veineux. Pour cette raison, nous étions contraints à une explantation du pontage et une ligature des 2 bouts de l'artère sans revascularisation. Malgré l'absence de revascularisation, l'évolution a été favorable sous couverture d'une une antibiothérapie adaptée. En cas d'anévrysme infectieux de l'axe fémoro-poplité par infection à salmonelle, le rétablissement de la continuité artérielle, même avec un greffon veineux, peut exposer au risque de rupture artérielle.

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Abstract: We report the first case of glenohumeral Salmonella arthritis in an immunocompetent 86-year-old woman. There was no entry point. An empirical antibiotherapy was started then adapted according to culture results. Given the persistence of symptoms, an arthroscopy was performed at 72hours for a joint lavage and synovectomy. Postoperative course was good. Apyrexia was obtained by 72hours and inflammatory syndrome was normalized in 12 days. The patient was reviewed regularly until the 3rd month. She has no clinical sequelae. Her osteoarthritis remained stable throughout follow-up. [Copyright &y& Elsevier]

Background To investigate the risk factors for infection with endemic typhoid fever in the Samarkand region of Uzbekistan. Methods Case–control study of culture-confirmed bloodstream infection with Salmonella Typhi. Patients were compared to age-matched community controls. Salmonella Typhi isolates were tested for antimicrobial susceptibility. Results We enrolled 97 patients and 192 controls. The median age of patients was 19 years. In a conditional regression model, consumption of unboiled surface water outside the home [adjusted odds ratio (aOR) = 3.0, 95% confidence interval (CI) = 1.1–8.2], use of antimicrobials in the 2 weeks preceding onset of symptoms (aOR = 12.2, 95% CI 4.0–37.0), and being a student (aOR = 4.0, 95% CI 1.4–11.3) were independently associated with typhoid fever. Routinely washing vegetables (aOR 0.06, 95% CI 0.02–0.2) and dining at a tea-house (aOR 0.4, 95% CI 0.2–1.0) were associated with protection against illness. Salmonella Typhi resistant to ampicillin, chloramphenicol, and trimethoprim-sulfamethoxazole was identified in 6 (15%) of 41 isolates tested. Conclusions Endemic typhoid fever in Uzbekistan is transmitted by contaminated water. Recent use of antimicrobials also increased risk of infection. Targeted efforts at improving drinking water quality, especially for students and young adults, are likely to decrease transmission of typhoid fever. Measures to decrease the unnecessary use of antimicrobials would be expected to reduce the risk of typhoid fever and decrease the spread of multiple drug-resistant Salmonella Typhi. [ABSTRACT FROM AUTHOR]

Abstract: Background: Thoracic infectious aortitis are currently rare. They are always lethal without any treatment. The microorganisms involved are numerous with particular pathophysiological characteristics for each bacterium. Treatment is difficult and must associate medical and surgical care. Recent findings: Bacterial epidemiology of infectious aortitis has been profoundly modified with the large use of antibiotics. Syphilitic aortitis were frequent in the beginning of the twentieth century but its incidence has dramatically felt. It still exists and its clinical presentation must be known to begin an adequate treatment. Other bacterial aetiologies of these aortitis are more classical with high frequencies of Staphylococcus aureus and Streptococcus, which are often associated with infective endocarditis. Among Gram-negative bacteria, Salmonella spp are the most frequently met microorganisms. Atherosclerosis represents the principal risk factor of these infectious aortitis. It provokes arterial parietal damage useful for bacterial attach. A saccular aneurism of infective origin can then appear. Treatment must consist on antibiotics before surgery; Tuberculous aortitis are also possible but are much more rare. Conclusion: Thoracic infectious aortitis are very rare but must be known because of their poor prognosis. Treatment is difficult and prevention of atherosclerosis which is the most important risk factor of these diseases is therefore of greatest importance. [Copyright &y& Elsevier]

Abstract: The authors report an unusual case of prosthetic vascular graft infection due to Salmonella typhimurium. The initial treatment combined antibiotherapy and surgical replacement of the arteriovenous graft. The infection relapsed within 6 weeks and was successfully treated with antibiotics only. Five cases of vascular graft infection due to Salmonella have been reported so far, but only one occurred in a previously healthy man and was not related to local infection, but to bacteremic seeding. Specific features of vascular graft infection and importance of prevention are discussed. [Copyright &y& Elsevier]

Summary: The need to limit unnecessary antibiotic treatments and recent studies with unusual antibiotics in pediatrics (fluoroquinolones) or in digestive tract infections (azithromycin) have led to update the treatment of acute gastro-enteritis. In 2007, the European Society for Pediatric Infectious Diseases and the European Society for Gastroenterology Hepatology and Nutrition have issued guidelines. The proven shigellosis as well as the strong suspicion have to be treated promptly with antibiotics, mainly azithromycin. There is no argument to treat moderate salmonella gastroenteritis or carriage. However, the severe cases and those occurring in high risk patient must be treated (ciprofloxacin or ceftriaxone). It is recommended to treat diarrhoea due to Campylobacter jejuni in case of early diagnosis. The presumptive antibiotic treatment should be limited but can not be dismissed, in invasive cases gastro-enteritis, especially in traveller children. [Copyright &y& Elsevier]