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12 results on '"Charline Miossec"'

1. Malaria in Martinique, French West Indies

Author

Nicole Desbois-Nogard, Fabrice Sonor, Elisabeth Fernandes, Charline Miossec, D.T. Nguyen, Pierre L Bonnet, André Yébakima, Groupe d'Étude des Interactions Hôte-Pathogène (GEIHP), Université d'Angers (UA), SFR UA 4208 Interactions Cellulaires et Applications Thérapeutiques (ICAT), Laboratoire de Parasitologie et Mycologiede [CHRU Brest], and Centre Hospitalier Régional Universitaire de Brest (CHRU Brest)

Subjects
biology, West Indies, [SDV]Life Sciences [q-bio], 030231 tropical medicine, Anopheles, biology.organism_classification, medicine.disease, Malaria, 03 medical and health sciences, 0302 clinical medicine, Infectious Diseases, Geography, medicine, Humans, Martinique, 030212 general & internal medicine, Socioeconomics, ComputingMilieux_MISCELLANEOUS, West indies
Abstract

International audience

Published
2022
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2. Pulmonary aspergillosis in critically ill patients with Coronavirus Disease 2019 (COVID-19)

Author

F. Wallet, Laurent Argaud, Florence Persat, Jean Turc, Jean Menotti, Jean-Christophe Richard, Charline Miossec, Martine Wallon, Damien Dupont, S. Paulus, Florence Ader, Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL), Centre de recherche en neurosciences de Lyon - Lyon Neuroscience Research Center (CRNL), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Physiopathologie de l'immunodépression associée aux réponses inflammatoires systémiques / Pathophysiology of Injury-induced Immunosuppression (PI3), Université de Lyon-Université de Lyon, Hôpital Edouard Herriot [CHU - HCL], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Centre International de Recherche en Infectiologie (CIRI), École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Hôpital Louis Pradel [CHU - HCL], Physiopathologie de l'immunodépression associée aux réponses inflammatoires systémiques - EA 7426 (PI3), Centre International de Recherche en Infectiologie - UMR (CIRI), École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), CarMeN, laboratoire, Centre de recherche en neurosciences de Lyon (CRNL), and Université de Lyon-Université de Lyon-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)

Subjects
Adult, Male, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Critical Illness, [SDV]Life Sciences [q-bio], Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Aspergillosis, intensive care unit, law.invention, 03 medical and health sciences, 0302 clinical medicine, law, Internal medicine, pulmonary aspergillosis, Pandemic, Humans, Medicine, 030212 general & internal medicine, Aged, Aged, 80 and over, Invasive Pulmonary Aspergillosis, 0303 health sciences, Aspergillus, biology, SARS-CoV-2, 030306 microbiology, Critically ill, business.industry, Brief Report, COVID-19, General Medicine, Middle Aged, acute respiratory distress syndrome, medicine.disease, biology.organism_classification, Intensive care unit, 3. Good health, [SDV] Life Sciences [q-bio], Intensive Care Units, Pulmonary aspergillosis, Infectious Diseases, AcademicSubjects/SCI00960, Female, AcademicSubjects/MED00010, business, COVID-19 associated pulmonary aspergillosis (CAPA)
Abstract

Occurrence of putative invasive pulmonary aspergillosis was screened in 153 consecutive adult intensive care unit (ICU) patients with respiratory samples addressed for mycological diagnosis during a 6-week period at the emergence of coronavirus disease 2019 (COVID-19) pandemic. Positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction (PCR) was observed for 106 patients (69.3%). Nineteen of them (17.9%) with positive Aspergillus results were considered as having putative invasive pulmonary aspergillosis. These observations underline the risk of pulmonary aspergillosis in COVID-19 patients, even in patients not previously known to be immunosuppressed, advocating active search for Aspergillus infection and prompt antifungal treatment. Standardized surveillance protocols and updated definitions for ICU putative invasive pulmonary aspergillosis are needed. Lay Abstract Adult ICU patients with respiratory samples addressed for mycological diagnosis were screened during the emergence of COVID-19 pandemic. Positive SARS-CoV-2 PCR was observed for 106 patients, nineteen of them (17.9%) having aspergillosis. This underlines the risk of aspergillosis in COVID-19 patients.

Published
2020
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3. Cerebral phaeohyphomycosis due to Cladophialophora bantiana in a French Guianese child

Author

Patrick Hochedez, N. Desbois, S. Jacob, E. Jolivet, A. Hamlat, L. Peipoch, M. Brard, and Charline Miossec

Subjects
Male, medicine.medical_specialty, Antifungal Agents, Brain Abscess, Cladophialophora bantiana, Ventriculoperitoneal Shunt, Neurosurgical Procedures, Flucytosine, 03 medical and health sciences, Enteral Nutrition, Ascomycota, Central Nervous System Fungal Infections, Humans, Medicine, Child, Abscess, Intubation, Gastrointestinal, Voriconazole, 0303 health sciences, 030306 microbiology, business.industry, Neurological status, Mortality rate, Pathogenicity, medicine.disease, Combined Modality Therapy, French Guiana, Surgery, Infectious Diseases, Cerebral Phaeohyphomycosis, business, Immunocompetence, medicine.drug
Abstract

We report a case of cerebral phaeohyphomycosis, a fungal brain infection due to a dark (dematiaceous) fungi in a 6-year-old French Guyanese boy. The child presented fever and drowsiness due to several paraventricular brain abscesses. Neurological surgeries were performed to reduce intracranial hypertension and to obtain abscess biopsies. Mycological cultures of intraoperative samples led to the diagnosis of cerebral phaeohyphomycosis due to Cladophialophora bantiana. The patient neurological status deteriorated and remained critical after several weeks of combination antifungal therapy with voriconazole 8 mg/kg/day, liposomal amphotericin B 10 mg/kg/day and flucytosine 200 mg/kg/day. A complete surgical resection was not possible because of multiple small abscesses. A multidisciplinary ethical staff decided on home medical care with palliative ventriculoperitoneal shunt, nasogastric feeding and analgesics. One year later, the patient's neurological condition had improved and cerebral lesions had regressed, while he had not received any antifungal treatment but only traditional medicines. Cerebral phaeohyphomycosis are rare diseases affecting immunocompromised but also apparently non-immunocompromised patients, as in this case. A complete surgical resection is not always possible and mortality rates are high in spite of treatments with a combination of antifungals. The diagnosis may be difficult because of these dematiaceous fungi's slowly growing and their potential pathogenicity for laboratory staff.

Published
2020
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4. First cases of Angiostrongylus cantonensis infection reported in Martinique, 2002–2017

Author

Nicole Desbois-Nogard, Eve Tessier, Christopher Swale, Katia de Meuron, André Cabié, Dorothée Harrois, Loïc Epelboin, Charline Miossec, Céline Dard, D.T. Nguyen, Centre Hospitalier Universitaire de Martinique [Fort-de-France, Martinique], University of Kyonggi, Ecosystemes Amazoniens et Pathologie Tropicale (EPat), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Guyane (UG), Université Grenoble Alpes (COMUE) (UGA), Maladies infectieuses et tropicales dans la Caraïbe (MAITC EA 4537), CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de la Martinique [Fort de France]-Université des Antilles (UA), Laboratoire de Parasitologie-Mycologie-Sérologies Bactériennes et Parasitaires [CHU de la Martinique], and Centre Hospitalier Universitaire de la Martinique - CHU Martinique

Subjects
Male, Pediatrics, medicine.medical_specialty, Eosinophilic Meningitis, [SDV]Life Sciences [q-bio], Veterinary (miscellaneous), 030231 tropical medicine, Biology, lcsh:Infectious and parasitic diseases, 030308 mycology & parasitology, 03 medical and health sciences, Fatal Outcome, 0302 clinical medicine, Eosinophilia, Helminth, medicine, Animals, Humans, lcsh:RC109-216, Martinique, Meningitis, Serologic Tests, Child, Retrospective Studies, Strongylida Infections, Anthelmintics, Caribbean, 0303 health sciences, Caribbean island, Angiostrongylus cantonensis, Infant, Middle Aged, medicine.disease, biology.organism_classification, 3. Good health, Infectious Diseases, Insect Science, Parasitic disease, Angiostrongyliasis, Encephalitis, Female, Animal Science and Zoology, Parasitology, Research Article
Abstract

Neuroangiostrongyliasis is a parasitic disease caused by the accidental ingestion of the nematode Angiostrongylus cantonensis in its larval form. Human infection can lead to eosinophilic meningitis, sometimes complicated by life-threatening radiculomyelitis or encephalitis. Although some cases have been reported from other Caribbean Islands, no cases have been diagnosed in Martinique so far. Here, we report the first eight laboratory-confirmed cases of neuroangiostrongyliasis on the island of Martinique, French West Indies, between 1 January 2002 and 31 December 2017. One case was fatal and five resulted in neurological sequelae. The medical community should consider the risk of A. cantonensis infection in patients living in or returning from Martinique.Premiers cas d’angiostrongylose à Angiostrongylus cantonensis à la Martinique, de 2002 à 2017.L’angiostrongylose neuroméningée est une maladie parasitaire causée par l’ingestion accidentelle du nématode Angiostrongylus cantonensis sous sa forme larvaire. L’infection humaine peut conduire à une méningite à éosinophiles, pouvant évoluer en radiculomyélite ou encéphalite menaçant le pronostic vital. Bien que des cas aient été rapportés dans d’autres îles des Caraïbes, aucun cas n’avait été diagnostiqué à la Martinique jusqu’à présent. Dans cet article, nous caractérisons les huit premiers cas d’angiostrongylose neuroméningée biologiquement diagnostiqués à la Martinique, Antilles françaises, entre le 1

Published
2020
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5. Human cryptosporidiosis in immunodeficient patients in France (2015–2017)

Author

Damien Costa, Romy Razakandrainibe, Marc Sautour, Stéphane Valot, Louise Basmaciyan, Gilles Gargala, Denis Lemeteil, Loïc Favennec, Frédéric Dalle, Anne Debourgogne, Adela Angoulvant, Patrice Agnamey, Julie bonhomme, Brigitte Degeilh, Cathy Chemla, Cécile Garnaud, Coralie Lollivier, Cécile angebault, Pascal Delaunay, Guillaume Desoubeaux, Emilie Fréalle, Frédéric Grenouillet, Florent Morio, Françoise Botterel, Ghania Belkadi, Hélène Yera, Gilles Nevez, Xavier Iriart, Isabelle Accoceberry, Julie Brunet, Marc Thellier, Meja Rabodonirina, Milene Sasso, Charline Miossec, Murielle Nicolas, Nicole Desbois, Philippe Poirier, Christelle Pomares, Sandrine Houze, Yohann Le govic, Anne Pauline Bellanger, Franck Labbe, Marie Laure Darde, Olivier Duquesnoy, Pierre Flori, Patrick Bastien, Thomas Gueudet, Isabelle Villena, Dominique Aubert, Estelle Cateau, Marie-Elisabeth Bougnoux, Nathalie Kapel, Eric Dannaoui, Alexis Valentin, Anne Totet, Jean Menotti, Denis Blanchet, Magalie Demar, Emmanuel Dutoit, Renaud Piarroux, Emilie Sitterle, Denis Magne, Samsa Hamane, Antoine Berry, Cecile Ramade, CHU Rouen, Normandie Université (NU), Institut Pasteur de Madagascar, Réseau International des Instituts Pasteur (RIIP), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Laboratoire de parasitologie mycologie (CHU de Dijon), Infections Parasitaires : Transmission, Physiopathologie et Thérapeutiques (IP-TPT), Service de Santé des Armées-Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU)-Institut de Recherche pour le Développement (IRD), Epidémiosurveillance de protozooses à transmission alimentaire et vectorielle (ESCAPE), Agence nationale de sécurité sanitaire de l'alimentation, de l'environnement et du travail (ANSES)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Université de Reims Champagne-Ardenne (URCA), Appareil Digestif Environnement Nutrition (ADEN ), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU), Service de Parasitologie-Mycologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Stress, Immunité, Pathogènes (SIMPA), Université de Lorraine (UL), Anofel Cryptosporidium National Network, Agents infectieux, résistance et chimiothérapie - UR UPJV 4294 (AGIR ), Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, Université de Caen Normandie (UNICAEN), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES), Centre Hospitalier Universitaire de Reims (CHU Reims), Université Grenoble Alpes - UFR Pharmacie (UGA UFRP), Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Université Paris Descartes - Paris 5 (UPD5), Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire de Nice (CHU Nice)-Hôpital l'Archet, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Institut Pasteur de Dakar, Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Centre hospitalier universitaire de Nantes (CHU Nantes), École nationale vétérinaire d'Alfort (ENVA), Service de parasitologie-mycologie [CHU Cochin], Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Laboratoire Universitaire de Biodiversité et Ecologie Microbienne (LUBEM), Université de Brest (UBO), CHU Bordeaux [Bordeaux], Microbiologie cellulaire et moléculaire et pathogénicité (MCMP), Université Bordeaux Segalen - Bordeaux 2-Centre National de la Recherche Scientifique (CNRS), Dynamique des interactions Hôte pathogène, Université de Strasbourg (UNISTRA), Immunité et Infection, Université Pierre et Marie Curie - Paris 6 (UPMC)-IFR113-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire de Parasitologie et Mycologie, Hospices Civils de Lyon (HCL), Biologie, Génétique et Pathologie des Pathogènes Eucaryotes (MIVEGEC-BioGEPPE), Pathogènes, Environnement, Santé Humaine (EPATH), Maladies infectieuses et vecteurs : écologie, génétique, évolution et contrôle (MIVEGEC), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Sud])-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Sud])-Maladies infectieuses et vecteurs : écologie, génétique, évolution et contrôle (MIVEGEC), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Sud])-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Sud]), Laboratoire de Parasitologie-Mycologie-Sérologies Bactériennes et Parasitaires [CHU de la Martinique], Centre Hospitalier Universitaire de la Martinique - CHU Martinique, Parasitologie-Mycologie Fort de France, CHU Fort de France, Laboratoire Microorganismes : Génome et Environnement (LMGE), Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), Hôpital Bichat - Claude Bernard, Service de parasitologie et mycologie [CHRU de Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Neuroépidémiologie Tropicale (NET), CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), Groupe Immunité des Muqueuses et Agents Pathogènes (GIMAP), Université Jean Monnet [Saint-Étienne] (UJM), CHU Clermont-Ferrand, Laboratoire de Parasitologie-Mycologie (LPM), IFR 53, Université de Reims Champagne-Ardenne (URCA)-Université de Reims Champagne-Ardenne (URCA)-CHU Maison Blanche-UPRES EA 2070, Centre de formation et de recherche sur l'environnement marin (CEFREM), Université de Perpignan Via Domitia (UPVD)-Institut national des sciences de l'Univers (INSU - CNRS)-Centre National de la Recherche Scientifique (CNRS), Ecologie et biologie des interactions (EBI), Université de Poitiers-Centre National de la Recherche Scientifique (CNRS), CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées, Departments of Medical Parasitology and Mycology, Service de réanimation médicale, Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Laboratoire Hospitalo-Universitaire de Parasitologie-Mycologie, Université des Antilles (UA)-Coordination Régionale de la lutte contre le Virus de L'Immunodéficience Humaine (COREVIH)-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Université de la Méditerranée - Aix-Marseille 2, Laboratoire de parasitologie mycologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe hospitalier Albert Chenevier – Henri Mondor, Service de Parasitologie et Mycologie, CHU Toulouse [Toulouse]-Institut Fédératif de Biologie (IFB) - Hôpital Purpan, Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse]-Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse], Région Haute Normandie, Projet COS Sesa, 2015-2018, Université de Reims Champagne-Ardenne (URCA)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Agence nationale de sécurité sanitaire de l'alimentation, de l'environnement et du travail (ANSES), Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Coordination Régionale de la lutte contre le Virus de L'Immunodéficience Humaine (COREVIH)-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]-Université des Antilles (UA), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Service de Santé des Armées, Université de Rennes (UR), Laboratoire Chrono-environnement (UMR 6249) (LCE), École nationale vétérinaire - Alfort (ENVA), Microbiologie Fondamentale et Pathogénicité (MFP), Université Jean Monnet - Saint-Étienne (UJM), Université de Toulouse (UT), Service de Parasitologie et Mycologie [CHU Toulouse], Institut Fédératif de Biologie (IFB), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Pôle Biologie [CHU Toulouse], and Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)

Subjects
0301 basic medicine, Male, Pediatrics, Epidemiology, Cryptosporidiosis, 0302 clinical medicine, Risk Factors, Child, Immunodeficiency, [SDV.MP.MYC]Life Sciences [q-bio]/Microbiology and Parasitology/Mycology, biology, Mortality rate, Cryptosporidium, General Medicine, Middle Aged, 3. Good health, Diarrhea, Infectious Diseases, Cryptosporidium parvum, Child, Preschool, Protozoan, Cyclosporine, Female, Immunotherapy, France, medicine.symptom, Cryptosporidium hominis, Immunosuppressive Agents, Adult, medicine.medical_specialty, Adolescent, 030231 tropical medicine, 030106 microbiology, Immunology, Context (language use), Tacrolimus, 03 medical and health sciences, Immunocompromised Host, Young Adult, medicine, Humans, [SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology, Immunocompromised, Aged, Immunosuppression Therapy, Infant, Newborn, Infant, Mycophenolic Acid, medicine.disease, biology.organism_classification, Parasitology
Abstract

International audience; Cryptosporidiosis is a common disease in children and immunodeficient individuals. In 2006, a national network was set up on the surveillance of human cryptosporidiosis in France. Since January 2015, the 41 tertiary care hospitals and the 3 private laboratories of the French National Network on the surveillance of human cryptosporidiosis have been able to declare confirmed cases of cryptosporidiosis online. Between 2015 and 2017, 210 cases of cryptosporidiosis were declared in immunodeficient patients in France; Cryptosporidium parvum and Cryptosporidium hominis represented 66% and 22% of cases, respectively. A peak was observed in autumn. Cryptosporidiosis occurred mainly in a context of solid organ transplantation (SOT) (49%) and of HIV infection (30%). In SOT recipients, cryptosporidiosis appeared more frequently in the first 6 months post transplantation. Regarding cases declared in SOT recipients, mycophenolate mofetil was used in 68%. A mortality rate of 6% was observed. Present results underline the importance of screening for cryptosporidiosis in immunocompromised patients suffering from diarrhea, especially in the course of major cell mediated immunodeficiency or even systematic screening before SOT. Exclusive Cryptosporidium free water feeding could be suggested during major cell mediated immunodeficiency.

Published
2018
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6. New Surge of Syphilis among Patients Living with Human Immunodeficiency Virus in Martinique in 2015

Author

Alain Putot, Nicole Desbois, Ingrid Laudarin, Patrick Hochedez, Charline Miossec, K Guitteaud, Sylvie Abel, André Cabié, Benoît Rozé, Sandrine Pierre-François, Mathilde Pircher, Rosalie Vilain, Service de Maladies Infectieuses et Tropicales [Fort-de-France, Martinique], CHU Fort de France-CHU de la Martinique [Fort de France]-Hôpital Pierre Zobda-Quitman [CHU de la Martinique], CHU de la Martinique [Fort de France], Service de médecine gériatrique (CHU de Dijon - Centre gériatrique de Champmaillot - EHPAD), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), CHU de la Martinique [Fort de France]-Hôpital Pierre Zobda-Quitman [CHU de la Martinique], CHU de la Martinique [Fort de France]-Centre Hospitalier Universitaire de Martinique [Fort-de-France, Martinique], Laboratoire de Parasitologie Mycologie Immunologie [Fort de France], CHU Fort de France, Parasitologie-Mycologie Fort de France, Centre d'investigation clinique Antilles-Guyane (CIC - Antilles Guyane), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU de la Martinique [Fort de France]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Maladies infectieuses et tropicales dans la Caraïbe (MAITC EA 4537), CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de la Martinique [Fort de France]-Université des Antilles (UA), This work was funded by Centre Hospitalier Universitaire de Martinique, France, CHU Fort de France-Hôpital Pierre Zobda-Quitman [CHU de la Martinique], CHU de la Martinique [Fort de France]-CHU de la Martinique [Fort de France], Centre d'Investigation Clinique Antilles Guyane, Inserm CIC1424, and Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de la Martinique [Fort de France]-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]

Subjects
0301 basic medicine, Adult, Male, Sexual Behavior, 030106 microbiology, Human immunodeficiency virus (HIV), HIV Infections, medicine.disease_cause, Disease Outbreaks, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Virology, Medicine, Humans, Martinique, 030212 general & internal medicine, Syphilis, business.industry, Incidence (epidemiology), Outbreak, virus diseases, Articles, medicine.disease, 3. Good health, Infectious Diseases, Sexual behavior, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Parasitology, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Demography
Abstract

International audience; A syphilis outbreak began in Martinique, French Antilles, in 2004, initially among men who had sex with men (MSM) and who were living with human immunodeficiency virus (HIV). The outbreak subsequently affected all groups at risk, leading to a first epidemic peak in 2008. After an initial decrease, the outbreak started growing again in 2014 among patients living with HIV with unprecedented incidence among MSM. Herein, we describe the change in medical and social parameters of the outbreak since 2005.

Published
2017
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7. Fatal Invasive Infection with Fungemia Due to Microascus cirrosus after Heart and Lung Transplantation in a Patient with Cystic Fibrosis

Author

Patrice Le Pape, Dea Garcia-Hermoso, Charline Miossec, Michel Miegeville, Françoise Gay-Andrieu, Thierry Lepoivre, Alain Haloun, Michele Treilhaud, Florent Morio, François Leclair, Centre hospitalier universitaire de Nantes (CHU Nantes), Université de Nantes (UN), Centre National de Référence des Mycoses invasives et antifongiques - Mycologie moléculaire (CNRMA), Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS), We are grateful to Francoise Dromer for fruitful discussions on the manuscript. We acknowledge Bernard Besse, Olivier Barre, and Damien Hoinard for technical assistance., and Institut Pasteur [Paris]-Centre National de la Recherche Scientifique (CNRS)

Subjects
Male, MESH: Histocytochemistry, MESH: Sequence Analysis, DNA, MESH: Fatal Outcome, Antifungal Agents, Cystic Fibrosis, medicine.medical_treatment, Case Reports, Cystic fibrosis, Echinocandins, chemistry.chemical_compound, Fatal Outcome, 0302 clinical medicine, MESH: Lipopeptides, Caspofungin, MESH: Immunocompromised Host, 030212 general & internal medicine, DNA, Fungal, [SDV.MP.MYC]Life Sciences [q-bio]/Microbiology and Parasitology/Mycology, Fungemia, Microscopy, 0303 health sciences, Histocytochemistry, MESH: Heart Transplantation, MESH: Voriconazole, 3. Good health, MESH: Caspofungin, Microascus, Pleura, Radiography, Thoracic, MESH: Tomography, X-Ray Computed, Lung Transplantation, medicine.drug, Adult, Microbiology (medical), medicine.medical_specialty, MESH: Microscopy, MESH: Cystic Fibrosis, Molecular Sequence Data, MESH: Ascomycota, Biology, Immunocompromised Host, Lipopeptides, 03 medical and health sciences, MESH: Mycoses, Ascomycota, MESH: Fungemia, medicine, Humans, Lung transplantation, Voriconazole, MESH: Humans, MESH: Molecular Sequence Data, 030306 microbiology, MESH: Echinocandins, MESH: Adult, Sequence Analysis, DNA, Triazoles, MESH: Radiography, Thoracic, MESH: Antifungal Agents, medicine.disease, biology.organism_classification, Dermatology, MESH: Male, Surgery, MESH: DNA, Fungal, Transplantation, Pyrimidines, MESH: Pleura, Mycoses, MESH: Triazoles, chemistry, MESH: Pyrimidines, Scopulariopsis, Heart Transplantation, MESH: Lung Transplantation, Tomography, X-Ray Computed
Abstract

Scopulariopsis species are rarely but increasingly recognized as opportunistic pathogens in immunocompromised patients. We report on a patient suffering from cystic fibrosis who developed disseminated fungal infection due to a rare Scopulariopsis species, Microascus cirrosus , after heart and lung transplantation. Despite antifungal combination therapy with voriconazole and caspofungin, the patient died 4 weeks after transplantation. Diagnostic difficulties and optimal management of disseminated Scopulariopsis / Microascus infections are discussed.

Published
2011
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8. Reaching the WHO target of testing persons in jails in prisons will need diverse efforts and resources

Author

Raymond Césaire, Marême Thioune, Charline Miossec, Séverine Da Cunha, Jean-Marie Bolivard, André Cabié, Lise Cuzin, Mathilde Pircher, Laurence Fagour, Sylvie Abel, Service de Maladies Infectieuses et Tropicales [Fort-de-France, Martinique], CHU Fort de France-CHU de la Martinique [Fort de France]-Hôpital Pierre Zobda-Quitman [CHU de la Martinique], CHU de la Martinique [Fort de France], Unité Médicale Pénitentiaire [Fort-de-France, Martinique], Centre Hospitalier Universitaire de Martinique [Fort-de-France, Martinique], Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire de Virologie-Immunologie [Fort de France, Martinique] (EA 4537), Laboratoire de Parasitologie-Mycologie-Sérologies Bactériennes et Parasitaires [CHU de la Martinique], Centre Hospitalier Universitaire de la Martinique - CHU Martinique, Maladies infectieuses et tropicales dans la Caraïbe (MAITC EA 4537), CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de la Martinique [Fort de France]-Université des Antilles (UA), Centre d'investigation clinique Antilles-Guyane (CIC - Antilles Guyane), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU de la Martinique [Fort de France]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de la Martinique [Fort de France]-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], and Centre d'Investigation Clinique Antilles Guyane, Inserm CIC1424

Subjects
Adult, Male, medicine.medical_specialty, media_common.quotation_subject, Population, lcsh:Medicine, HIV Infections, Prison, World Health Organization, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Humans, Mass Screening, Medicine, Martinique, Syphilis, 030212 general & internal medicine, Young adult, lcsh:Science, education, Mass screening, media_common, Human T-lymphotropic virus 1, education.field_of_study, 030505 public health, Multidisciplinary, business.industry, Prisoners, lcsh:R, virus diseases, Hepatitis B, medicine.disease, HTLV-I Infections, Hepatitis C, 3. Good health, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Prisons, Family medicine, Population study, lcsh:Q, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Female, Observational study, 0305 other medical science, business
Abstract

Background The Caribbean is the second most affected region in the world by human immunodeficiency virus (HIV), and HIV prevalence is significantly higher among persons in jails and prisons than in the free population. The aim of our study was to assess the screening rates of HIV, hepatitis B and C, syphilis and human T cell leukaemia virus type 1 among newly-arrived persons in 2014, at Ducos facility in Martinique and the testing process performance. Methods This is an observational monocentric study conducted within the prison’s health unit. The study population consisted of all individuals incarcerated between 01/01/14 and 31/12/14. At the initial medical visit, HIV and STI testing were proposed to every newcomer. The rate of acceptance was calculated, as well as the screening process performance. Results In 2014 778 new persons were incarcerated, among those, 461 (59.3%) were tested. The main reasons for missing the testing opportunity were due to organization of the judiciary system (persons on electronic monitoring or day parole, transferred or quickly released before completion of the process) or to individual refusal. Finally, 75 persons did not get their results (all of them negative), 41 of them due to the medical staff work overload. Conclusions HIV and STI testing rates among newcomers at Ducos have notable room for improvement. The future availability of combined (HIV, HBV, HCV and syphilis) rapid tests may be very useful in case of short term incarceration, if their cost is not prohibitive. Reaching higher levels of testing will also require more resources.

Published
2018
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9. First Case of Visceral Leishmaniasis Caused by Leishmania martiniquensis

Author

Yves Plumelle, Christophe Ravel, Moumini Kone, Charline Miossec, Nicole Desbois, Nicolas Vignier, Delphine . Delta, André Cabié, Bernard Liautaud, CHU de la Martinique [Fort de France], Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Biologie, Génétique et Pathologie des Pathogènes Eucaryotes (MIVEGEC-BioGEPPE), Pathogènes, Environnement, Santé Humaine (EPATH), Maladies infectieuses et vecteurs : écologie, génétique, évolution et contrôle (MIVEGEC), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Sud])-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Sud])-Maladies infectieuses et vecteurs : écologie, génétique, évolution et contrôle (MIVEGEC), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Sud])-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Sud]), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre d'Investigation Clinique Antilles-Guyane (CIC - Antilles Guyane), CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Institut National de la Santé et de la Recherche Médicale (INSERM)-Université des Antilles et de la Guyane (UAG), Maladies infectieuses et tropicales dans la Caraïbe (MAITC EA 4537), CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de la Martinique [Fort de France]-Université des Antilles (UA), and Université des Antilles et de la Guyane (UAG)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]

Subjects
Male, Anemia, AIDS-Related Opportunistic Infections, Hepatosplenomegaly, Cutaneous leishmaniasis, Amphotericin B, Virology, Humans, Medicine, Martinique, Leishmania, biology, business.industry, Leishmaniasis, Articles, Middle Aged, medicine.disease, biology.organism_classification, Trypanocidal Agents, 3. Good health, Infectious Diseases, Visceral leishmaniasis, Immunology, Leishmaniasis, Visceral, Parasitology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, medicine.symptom, business
Abstract

International audience; We report the first case of visceral leishmaniasis (VL) caused by Leishmania martiniquensis in the Caribbean, which until now, was known only to cause cutaneous leishmaniasis. The disease presented with fatigue, anemia, and hepatosplenomegaly in a 61-year-old man with human immunodeficiency virus (HIV) infection who was receiving antiretroviral therapy. Diagnosis was made by bone marrow biopsy. VL is life-threatening, and its emergence in the Caribbean is of concern.

Published
2015
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10. A 43-year-old Brazilian man with a chronic ulcerated lesion

Author

Charline Miossec, Sarah Milley, Christine Aznar, Pierre Couppié, Denis Blanchet, and Marie Cheuret

Subjects
Microbiology (medical), Adult, Male, Pathology, medicine.medical_specialty, Lacazia, Biopsy, Lesion, Skin Ulcer, medicine, Humans, Lobomycosis, Lepromatous leprosy, Microscopy, Chromoblastomycosis, Sporotrichosis, biology, medicine.diagnostic_test, business.industry, Histocytochemistry, medicine.disease, biology.organism_classification, Infectious Diseases, Skin biopsy, medicine.symptom, business, Brazil
Abstract

Diagnosis: lacaziosis, or lobomycosis [1]. The diagnosis was confirmed by direct examination of the skin biopsy, highlighting the presence of round or oval yeastlike organisms 6–12 μm in diameter, either isolated or in chains, with a birefringent membrane (Figure 1). The periodic acid-Schiff–stained and the Gomori-Grocott methenamine silver–stained sections of the sample revealed short chains of lemon-shaped fungal cells connected by thin, tubelike bridges (Figure 2). Morphology was consistent with the appearance of Lacazia loboi. There was a minor improvement of the lesion after pentamidine treatment, whereas the Leishmania research by microscopic examination, culture, and molecular biology was negative. However, these exams were done after treatment initiation, so an initial coinfection cannot be ruled out. Mycological culturesonSabouraud-gentamicin-cycloheximide withandwithout actidionewereperformedandwerenegativeafter 2 months. The patient is currently under treatment with terbinafine (250 mg twice daily), awaiting surgical excision of the lesion. Lacaziosis, or lobomycosis [1], is a chronic infectious disease that was first described in 1930 in Brazil by the dermatologist Jorge Lobo [2]. Since then, >500 human cases have been reported [3], mainly in Central and South America. The etiological agent, Lacazia loboi ( formerly known as Loboa loboi), an Onygenales dimorphic fungus [4], seems to be saprophytic in vegetation, soil, and water. It gains access to the skin following cutaneous traumatism, or animal bites [5]. After the initial lesion, there is a slow local dissemination period leading to pleomorphic lesions. The typical clinical aspect is generally multiple keloidal lesions, with a smooth, shiny aspect, but can also appear as papules, nodules, ulcers, sclerodermiform, or verrucous plaques [6]. These lesions are painless and hypoor hyperchromic. Clinical diagnosis is generally difficult because of pathology scarcity and frequently atypical cases. For example, infiltrated plaque-type lesions can be mistaken for cutaneous leishmaniasis; lesions with a keloidal aspect can be mistaken for lepromatous leprosy [7]; and lesions with a verrucous, vegetating, or nodular aspect can be mistaken for sporotrichosis, chromoblastomycosis, paracoccidioidomycosis, keloids, or neoplastic processes [6]. The diagnosis is based onmacroscopic examination of the lesions and on direct microscopic examination of biopsy or curettage. The diagnostic feature of Lacazia loboi is the chain of samesized buds, unlike Paracoccidioides, whose buds are smaller than the mother cell. Figure 1. Skin biopsy: round or oval yeast-like organisms from 6 to 12 μm in diameter, isolated or in chains with a bi-refringent membrane; direct microscopic examination (×1000 magnification). Figure 2. Skin biopsy section. Short chains of lemon-shaped fungal cells connected by thin, tubelike bridges (arrow). A, Periodic acidSchiff stain. B, Gomori-Grocott methenamine silver stain (×1000 magnification).

Published
2014

11. Ovarian reserve in young women of reproductive age with Crohn's disease

Author

Stanislas Bruley des Varannes, Mathurin Flamant, Arnaud Bourreille, Paul Barrière, Kalyane Bach-Ngohou, Charline Miossec, Olivier Maillard, Thomas Dejoie, Damien Masson, Marc G. Denis, and Thomas Fréour

Subjects
Adult, Anti-Mullerian Hormone, endocrine system, medicine.medical_specialty, Physiology, Inflammatory bowel disease, Young Adult, Crohn Disease, Pregnancy, medicine, Immunology and Allergy, Humans, Young adult, Ovarian reserve, Retrospective Studies, Gynecology, Crohn's disease, biology, business.industry, Reproduction, Ovary, Gastroenterology, Case-control study, Age Factors, Retrospective cohort study, Anti-Müllerian hormone, medicine.disease, Prognosis, Case-Control Studies, biology.protein, Female, France, business, Biomarkers, Follow-Up Studies
Abstract

Background: Crohn's disease (CD) mainly affects young adults of reproductive age. Whereas a large amount of data is available concerning pregnancy in young CD women, no study has been conducted on their ovarian reserve status. This study aimed to investigate the potential effect of CD on ovarian reserve in young women in remission, as reflected by serum anti-Mullerian hormone (AMH). Methods: This retrospective case-control study was conducted in the University Hospital of Nantes, France. Serum levels of AMH were retrospectively measured in 50 women with CD in remission and in 163 control women with normal ovarian reserve, matched by age. Results: No statistical difference was found between mean serum AMH levels in CD and control women. Serum AMH levels remained comparable between CD and control women

Published
2011

12. Guillain-Barré Syndrome Associated With Zika Virus Infection in Martinique in 2016: A Prospective Study

Author

Benoît, Rozé, Fatiha, Najioullah, Jean-Louis, Fergé, Frédérique, Dorléans, Kossivi, Apetse, Jose-Luis, Barnay, Elise, Daudens-Vaysse, Yannick, Brouste, Raymond, Césaire, Laurence, Fagour, Ruddy, Valentino, Martine, Ledrans, Hossein, Mehdaoui, Sylvie, Abel, Isabelle, Leparc-Goffart, Aissatou, Signate, André, Cabié, Rosalie, Vilain, Service de Maladies Infectieuses et Tropicales [Fort-de-France, Martinique], CHU Fort de France-CHU de la Martinique [Fort de France]-Hôpital Pierre Zobda-Quitman [CHU de la Martinique], CHU de la Martinique [Fort de France], Unité de soins intensifs [CHU Martinique], Hôpital Pierre Zobda-Quitman [CHU de la Martinique], CHU de la Martinique [Fort de France]-CHU de la Martinique [Fort de France], Laboratoire de Virologie-Immunologie [Fort de France, Martinique] (EA 4537), Centre Hospitalier Universitaire de Martinique [Fort-de-France, Martinique], Unité Régionale Antilles Guyane [Saint-Maurice] (Agence Nationale de la Santé Publique ), Département d'Electrophysiologie [Fort de France, Martinique], Unité de Réhabilitation [Fort de France, Martinique], Hôpital Le Lamentin Bourg [CHU de la Martinique], Service d'Urgence [Fort de France, Martinique], Institut de Recherche Biomédicale des Armées [Antenne Marseille] (IRBA), Environnement, Santé, Sociétés (ESS), Centre National de la Recherche Scientifique (CNRS), Service de neurologie [Fort-de-France, Martinique], CHU de la Martinique [Fort de France]-Hôpital Pierre Zobda-Quitman [CHU de la Martinique], CHU de la Martinique [Fort de France]-Centre Hospitalier Universitaire de Martinique [Fort-de-France, Martinique], Centre d'Investigation Clinique Antilles-Guyane (CIC - Antilles Guyane), CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Institut National de la Santé et de la Recherche Médicale (INSERM)-Université des Antilles et de la Guyane (UAG), This research was sponsored by University Hospital of Martinique (UHM) for regulatory and ethic submission and supported by the Clinical Research Hospital Program from the French Ministry of Health (PHRC 2009, NCT01099852). This research was support by the French network for Research and Action targeting emerging infectious diseases (REACTING)., Guillain-Barré Syndrome Zika Working Group of Martiniquea : Gwenole Jean Abgrall, Véronique Aïm, Alessandro Arrigo, Philippe Cabre, Cyrille Chabartier, Sylvie Colombani, Julien Cuziat, Christophe Deligny, Nicole Desbois, Anne-Laure Dessoy, Gaëlle Dunoyer, Régis Duvauferrier, N’Guyen Duc, Mireille Edimonana, Pierre Garrigou, Stéphane Gaucher, Sarah Gourgoudou, Karine Guitteaud, Patrick Hochedez, Gwladys Ivanes, Yolène Jacquens, Sandrine Julié, Armelle Jean-Etienne, Séverine Jeannin, Joux Julien, Pasquier Jérémie, Jean- Louis Lamaignère, Ingrid Laudarin, Maud Le Gall, Véronique Legris- Allusson, Mehdi Mejdoubi, Corinne Michel, Franck Michel, Charline Miossec, Florence Moinet, Cervantes Minerva, Claude Olive, Pascale Olive, Karine Pailla, Céline Paysant, Sandrine Pierre-François, Mathilde Pircher, Katlyne Polomat, Alain Putot, Patrick René-Corail, Dabor Resiere, Christiane Richer, Jean-Romain Risson, Karen Rome, Marie Sabia, Michel Schloesser, Pauline Simonnet-Vigeral, Rafaelle Théodose, Rosalie Vilain., Université des Antilles et de la Guyane (UAG)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], and BUISINE, Soline

Subjects
Microbiology (medical), Male, Pediatrics, medicine.medical_specialty, 030231 tropical medicine, Guillain-Barre Syndrome, Zika virus, Serology, Disease Outbreaks, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Intensive care, Medicine, Humans, Martinique, Prospective Studies, Aged, [SDV.MP.VIR] Life Sciences [q-bio]/Microbiology and Parasitology/Virology, [SDV.MHEP.ME] Life Sciences [q-bio]/Human health and pathology/Emerging diseases, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, biology, Guillain-Barre syndrome, business.industry, Outbreak, Retrospective cohort study, vector-borne infections, Zika Virus, Middle Aged, Zika virus infection, biology.organism_classification, medicine.disease, bacterial infections and mycoses, Guillain-Barré syndrome, 3. Good health, Infectious Diseases, outbreaks, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Etiology, Female, business, 030217 neurology & neurosurgery
Abstract

International audience; Background: Guillain-Barré syndrome (GBS) has been reported to be associated with Zika virus (ZIKV) infection in case reports and retrospective studies, mostly on the basis of serological tests, with the problematic cross-reacting antibodies of the Flavivirus genus. Some GBS cases do not exhibit a high level of diagnostic certainty. This prospective study aimed to describe the clinical profiles and the frequency of GBS associated with ZIKV during the ZIKV outbreak in Martinique in 2016.Methods: We recorded prospective data from GBS meeting levels 1 or 2 of diagnostic certainty for the Brighton Collaboration, with proof of recent ZIKV infection and negative screening for etiologies of GBS.Results: Of the sample of 34 patients with suspected GBS during the outbreak, 30 had a proven presence of GBS, and 23 had a recent ZIKV infection. The estimated GBS incidence rate ratio (2016 vs 2006-2015) was 4.52 (95% confidence interval, 2.80-7.64; P = .0001). Recent ZIKV infection was confirmed by urine reverse-transcription polymerase chain reaction (RT-PCR) analysis in 17 cases and by serology in 6 cases. Patients, 65% of whom were male, had a median age of 61 years (interquartile range, 56-71 years) and experienced severe GBS. Electrophysiological tests were consistent with the primary demyelinating form of the disease.Conclusions: ZIKV infection is usually benign, when symptomatic, but in countries at risk of ZIKV epidemics, adequate intensive care bed capacity is required for management of severe GBS cases. Arbovirus RNA detection by RT-PCR should be part of the management of GBS cases.

Published
2017
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