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Ngo Bell EC, Chapon V, Bessede E, Meriglier E, Issa N, Domblides C, Bonnet F, Vandenhende MA. Central venous catheter-related bloodstream infections: Epidemiology and risk factors for hematogenous complications. Infect Dis Now 2024; 54:104859. [PMID: 38309647 DOI: 10.1016/j.idnow.2024.104859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 12/08/2023] [Accepted: 01/29/2024] [Indexed: 02/05/2024]
Abstract
BACKGROUND Central catheter-related bloodstream infections (CRBIs) can lead to severe complications, including suppurative thrombophlebitis, endocarditis, and metastatic infections. While complications due to CRBIs caused by Staphylococcus aureus (SA) are well-known, there are limited data regarding CRBIs caused by other bacteria. METHODS This 2-year retrospective single-center study of patients with CRBIs from a tertiary care hospital examined the hematogenous complications associated with CRBIs according to patient characteristics, central venous catheter (CVC) types, and causative bacteria. RESULTS All in all, 254 patients with confirmed CRBIs were included; 285 bacteria types were isolated, mainly Enterobacteriaceae (n = 94), coagulase-negative Staphylococci (CNS, n = 82), SA (n = 45), and non-fermenting Gram-negative bacteria (NGB, n = 45). Among the patients, 35 developed at least one hematogenous complication (14 %), including suppurative thrombophlebitis (n = 15), endocarditis (n = 7) and metastatic infections (n = 16). In multivariate analysis, hemodialysis, persistent bacteremia for at least 3 days, and CRBIs caused by SA were associated with increased risk for hematogenous complications, while previous curative anticoagulant treatment was associated with reduced risk. Diabetes, CVC maintenance, and hematogenous complications were associated with increased 3-month mortality. CONCLUSION A thorough investigation of hematogenous complications should be envisioned in patients with persistent bacteremia, particularly those with SA infections and those on hemodialysis.
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Affiliation(s)
| | - Virginie Chapon
- Centre Hospitalier Universitaire de Bordeaux, Service de Médecine Interne et Maladies Infectieuses, Hôpital Saint-André, F-33000 Bordeaux, France.
| | - Emilie Bessede
- Centre Hospitalier Universitaire de Bordeaux, Laboratoire de Bactériologie, Hôpital Pellegrin, F-33000 Bordeaux, France.
| | - Etienne Meriglier
- Centre Hospitalier Universitaire de Bordeaux, Service de Médecine Interne, Hôpital Pellegrin, INSERM, Institut Bergonié, CIC-EC 1401, F-33000 Bordeaux, France.
| | - Nahema Issa
- Centre Hospitalier Universitaire de Bordeaux, Service de Réanimation médicale, Hôpital Saint-André, F-33000 Bordeaux, France.
| | - Charlotte Domblides
- Centre Hospitalier Universitaire de Bordeaux, Service d'Oncologie médicale, Hôpital Saint-André, F-33000 Bordeaux, France.
| | - Fabrice Bonnet
- Centre Hospitalier Universitaire de Bordeaux, Service de Médecine Interne et Maladies Infectieuses, Hôpital Saint-André, F-33000 Bordeaux, France; Université de Bordeaux, INSERM, BPH, U1219, F-33000 Bordeaux, France.
| | - Marie-Anne Vandenhende
- Centre Hospitalier Universitaire de Bordeaux, Service de Médecine Interne, Hôpital Pellegrin, INSERM, Institut Bergonié, CIC-EC 1401, F-33000 Bordeaux, France; Université de Bordeaux, INSERM, Institut Bergonié, CIC-EC 1401, F-33000 Bordeaux, France.
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Martin-Lecamp G, Vandenhende MA, Meriglier E. [A complicated cystitis]. Rev Med Interne 2024:S0248-8663(24)00033-X. [PMID: 38336584 DOI: 10.1016/j.revmed.2024.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 01/20/2024] [Indexed: 02/12/2024]
Affiliation(s)
- G Martin-Lecamp
- Service de médecine interne et post-urgences, Centre Hospitalier Universitaire de Bordeaux, Hôpital Pellegrin, place Amélie Rabat-Léon, 33000 Bordeaux, France.
| | - M-A Vandenhende
- Service de médecine interne et post-urgences, Centre Hospitalier Universitaire de Bordeaux, Hôpital Pellegrin, place Amélie Rabat-Léon, 33000 Bordeaux, France
| | - E Meriglier
- Service de médecine interne et post-urgences, Centre Hospitalier Universitaire de Bordeaux, Hôpital Pellegrin, place Amélie Rabat-Léon, 33000 Bordeaux, France
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3
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De Fontcuberta P, Vandenhende MA, Laux M, Tourbier B, Paz R, Bonnet F, Meriglier E. [Hearing loss in giant cell arteritis: A case report]. Rev Med Interne 2023; 44:31-34. [PMID: 35752483 DOI: 10.1016/j.revmed.2022.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/17/2022] [Accepted: 05/23/2022] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Hearing loss is a rare manifestation in giant cell arteritis. The different types of deafness are possible with a predominance of sensorineural deafness. CASE REPORT We report a 75-year-old woman who presented with typical manifestations of giant cell arteritis associated concomitantly with the occurrence of bilateral mixed hearing loss confirmed on the audiogram. Corticosteroids allowed a rapidly favorable clinical and biological outcome. The follow-up audiogram at 3 months was markedly improved and showed a decrease in sensorineural hearing loss and disappearance of conductive hearing loss. CONCLUSION Any rapid onset deafness in an inflammatory context in the elderly should lead to a search for giant cell arteritis. The diagnosis can be difficult in the absence of other typical manifestations, especially since the biopsy of the temporal artery most often comes back negative. Corticosteroids are usually effective.
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Affiliation(s)
- Pedro De Fontcuberta
- Service de médecine interne et post-urgences, hôpital Pellegrin, CHU de Bordeaux, hôpital Pellegrin, place Amélie Raba Léon, 33000 Bordeaux, France
| | - Marie-Anne Vandenhende
- Service de médecine interne et post-urgences, hôpital Pellegrin, CHU de Bordeaux, hôpital Pellegrin, place Amélie Raba Léon, 33000 Bordeaux, France; Université de Bordeaux, Talence, France
| | - Miranda Laux
- Service de médecine interne et post-urgences, hôpital Pellegrin, CHU de Bordeaux, hôpital Pellegrin, place Amélie Raba Léon, 33000 Bordeaux, France
| | - Benjamin Tourbier
- Service de médecine interne et post-urgences, hôpital Pellegrin, CHU de Bordeaux, hôpital Pellegrin, place Amélie Raba Léon, 33000 Bordeaux, France
| | - Rafael Paz
- Service de médecine interne et post-urgences, hôpital Pellegrin, CHU de Bordeaux, hôpital Pellegrin, place Amélie Raba Léon, 33000 Bordeaux, France
| | - Fabrice Bonnet
- Université de Bordeaux, Talence, France; Service de médecine interne et maladies infectieuses, hôpital Saint-André, CHU de Bordeaux, Bordeaux, France
| | - Etienne Meriglier
- Service de médecine interne et post-urgences, hôpital Pellegrin, CHU de Bordeaux, hôpital Pellegrin, place Amélie Raba Léon, 33000 Bordeaux, France; Université de Bordeaux, Talence, France.
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Prola J, Martin-Lecamp G, Meriglier E, Duffau P, Pellegrin J, Bonnet F, Vandenhende M. Incidence et facteurs de risque d’infection sévère sous Rituximab chez des patients atteints de maladies immuno-inflammatoires. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.10.244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Meriglier E, Lafourcade F. [Sarcoidosis coming from the galaxy]. Rev Mal Respir 2022; 39:618-620. [PMID: 35764506 DOI: 10.1016/j.rmr.2022.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 05/19/2022] [Indexed: 10/17/2022]
Abstract
Manifestations of sarcoidosis are variable and non-specific. We are reporting on the case of a 23-year-old man who presented multiple bilateral pulmonary nodules spiculated with peripherical micronodules (galaxy sign). He had no clinical symptom. Investigations led to the diagnosis of sarcoidosis. The galaxy sign is a rare manifestation of sarcoidosis which can be useful for diagnosis.
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Affiliation(s)
- E Meriglier
- Service de médecine interne et post-urgences, CHU de Bordeaux, hôpital Pellegrin, 33000 Bordeaux.
| | - F Lafourcade
- Centre d'imagerie scanner imagerie du Béarn, 64000 Pau, France
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Meriglier E, Abergel A, Michelson-Lechat X, Gorisse V, Lapoirie J, Rivoisy C, Vandenhende MA, Bonnet F. Diagnosis of genital tuberculosis on menstrual blood during infertility explorations. Eur J Obstet Gynecol Reprod Biol 2021; 262:259-261. [PMID: 34090731 DOI: 10.1016/j.ejogrb.2021.05.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 05/17/2021] [Accepted: 05/19/2021] [Indexed: 11/28/2022]
Affiliation(s)
- E Meriglier
- Service de Médecine Interne et Post-Urgences, Hôpital Pellegrin, CHU de Bordeaux, France; Service de médecine interne et maladies infectieuses, Hôpital Saint André, CHU de Bordeaux, France; Université de Bordeaux, Bordeaux, France.
| | - A Abergel
- Centre de fertilité GAIA, Polyclinique Jean Villar, Bruges, France.
| | | | - V Gorisse
- Service de médecine interne et maladies infectieuses, Hôpital Saint André, CHU de Bordeaux, France; Service de médecine interne et maladies infectieuses, Hôpital Saint André, CHU de Bordeaux, France; Université de Bordeaux, Bordeaux, France.
| | - J Lapoirie
- Service de médecine interne et maladies infectieuses, Hôpital Saint André, CHU de Bordeaux, France; Service de médecine interne et maladies infectieuses, Hôpital Saint André, CHU de Bordeaux, France; Université de Bordeaux, Bordeaux, France.
| | - C Rivoisy
- Service de médecine interne et maladies infectieuses, Hôpital Saint André, CHU de Bordeaux, France; Service de médecine interne et maladies infectieuses, Hôpital Saint André, CHU de Bordeaux, France; Université de Bordeaux, Bordeaux, France.
| | - M A Vandenhende
- Service de Médecine Interne et Post-Urgences, Hôpital Pellegrin, CHU de Bordeaux, France; Service de médecine interne et maladies infectieuses, Hôpital Saint André, CHU de Bordeaux, France; Université de Bordeaux, Bordeaux, France.
| | - F Bonnet
- Université de Bordeaux, Bordeaux, France; Service de médecine interne et maladies infectieuses, Hôpital Saint André, CHU de Bordeaux, France.
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Nallet A, Rivoisy C, Meriglier E, Bronnimann D, Bonnet F. Quand la chirurgie esthétique se complique. Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.03.165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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8
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Meriglier E, Rivoisy C, Hessamfar M, Bernard N, Aureau I, Lapoirie J, Contis A, Sacher F, Sacristan B, Lahouati M, Pedeboscq S, Vandenhende MA, Bouchet S, Bonnet F. Safety of hydroxychloroquine and darunavir or lopinavir in COVID-19 infection. J Antimicrob Chemother 2021; 76:482-486. [PMID: 33221868 PMCID: PMC7717306 DOI: 10.1093/jac/dkaa441] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 09/29/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Combination therapy with hydroxychloroquine and darunavir/ritonavir or lopinavir/ritonavir has been suggested as an approach to improve the outcome of patients with moderate/severe COVID-19 infection. OBJECTIVES To examine the safety of combination therapy with hydroxychloroquine and darunavir/ritonavir or lopinavir/ritonavir. METHODS This was an observational cohort study of patients hospitalized for COVID-19 pneumonia treated with hydroxychloroquine and darunavir/ritonavir or lopinavir/ritonavir. Clinical evaluations, electrocardiograms and the pharmacokinetics of hydroxychloroquine, darunavir and lopinavir were examined according to clinical practice and guidelines. RESULTS Twenty-one patients received hydroxychloroquine with lopinavir/ritonavir (median age 68 years; 10 males) and 25 received hydroxychloroquine with darunavir/ritonavir (median age 71 years; 15 males). During treatment, eight patients (17.4%) developed ECG abnormalities. Ten patients discontinued treatment, including seven for ECG abnormalities a median of 5 (range 2-6) days after starting treatment. All ECG abnormalities reversed 1-2 days after interrupting treatment. Four patients died within 14 days. ECG abnormalities were significantly associated with age over 70 years, coexisting conditions (such as hypertension, chronic cardiovascular disease and kidney failure) and initial potential drug interactions, but not with the hydroxychloroquine concentration. CONCLUSIONS Of the patients with COVID-19 who received hydroxychloroquine with lopinavir or darunavir, 17% had ECG abnormalities, mainly related to age or in those with a history of cardiovascular disease.
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Affiliation(s)
- Etienne Meriglier
- CHU de Bordeaux, Service de médecine interne et maladies infectieuses, Hôpital Saint-André, F-33000 Bordeaux, France.,Univ. Bordeaux, F-33000 Bordeaux, France
| | - Claire Rivoisy
- CHU de Bordeaux, Service de médecine interne et maladies infectieuses, Hôpital Saint-André, F-33000 Bordeaux, France
| | - Mojgan Hessamfar
- CHU de Bordeaux, Service de médecine interne et maladies infectieuses, Hôpital Saint-André, F-33000 Bordeaux, France
| | - Noelle Bernard
- CHU de Bordeaux, Service de médecine interne et maladies infectieuses, Hôpital Saint-André, F-33000 Bordeaux, France
| | - Ines Aureau
- CHU de Bordeaux, Service de médecine interne et maladies infectieuses, Hôpital Saint-André, F-33000 Bordeaux, France
| | - Joelle Lapoirie
- CHU de Bordeaux, Service de médecine interne et maladies infectieuses, Hôpital Saint-André, F-33000 Bordeaux, France.,Univ. Bordeaux, F-33000 Bordeaux, France
| | - Anne Contis
- CHU de Bordeaux, Service de médecine interne et maladies infectieuses, Hôpital Saint-André, F-33000 Bordeaux, France
| | - Frédéric Sacher
- Univ. Bordeaux, F-33000 Bordeaux, France.,IHU LIRYC, Université de Bordeaux, CHU de Bordeaux, Service de cardiologie, Hôpital Haut-Lévêque, F-33000 Bordeaux, France
| | | | - Marin Lahouati
- CHU de Bordeaux, Service de pharmacie clinique des médicaments, Hôpital Saint-André, F-33000 Bordeaux, France
| | - Stéphane Pedeboscq
- CHU de Bordeaux, Service de pharmacie clinique des médicaments, Hôpital Saint-André, F-33000 Bordeaux, France
| | - Marie-Anne Vandenhende
- CHU de Bordeaux, Service de médecine interne et maladies infectieuses, Hôpital Saint-André, F-33000 Bordeaux, France.,Univ. Bordeaux, F-33000 Bordeaux, France
| | - Stéphane Bouchet
- CHU de Bordeaux, Laboratoire de pharmacologie - toxicologie, Hôpital Pellegrin, F-33000 Bordeaux, France
| | - Fabrice Bonnet
- CHU de Bordeaux, Service de médecine interne et maladies infectieuses, Hôpital Saint-André, F-33000 Bordeaux, France.,Univ. Bordeaux, F-33000 Bordeaux, France
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Martin-Lecamp G, Chaussade H, Andre K, Rivoisy C, Issa N, Meriglier E, Bonnet F, Vandenhende M. Une polyarthrite septique d’évolution défavorable : quand une bactérie peut en cacher une autre. Rev Med Interne 2020. [DOI: 10.1016/j.revmed.2020.10.269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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10
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Meriglier E, Lafourcade F, Gombert B, Landron C. Giant calcinosis revealing systemic sclerosis. Int J Rheum Dis 2019; 22:1787-1788. [DOI: 10.1111/1756-185x.13648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 04/23/2019] [Accepted: 05/27/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Etienne Meriglier
- Department of Internal Medicine CHU Poitiers Poitiers France
- INSERM U1070 Poitiers France
| | | | - Bruno Gombert
- Department of Rheumatology CH La Rochelle La Rochelle France
| | - Cedric Landron
- Department of Internal Medicine CHU Poitiers Poitiers France
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Meriglier E, Michaud A, Plouzeau C, Raud-Raynier P, Burucoa C, Roblot F. A fatal case of Streptococcus uberis endocarditis on cardiovascular implantable electronic device. Med Mal Infect 2018; 48:549-551. [DOI: 10.1016/j.medmal.2018.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 03/30/2018] [Accepted: 07/24/2018] [Indexed: 11/27/2022]
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12
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Meriglier E, Sunder A, Elsendoorn A, Canoui E, Rammaert B, Million M, Raoult D, Roblot F. Osteoarticular manifestations of Q fever: a case series and literature review. Clin Microbiol Infect 2018; 24:912-913. [DOI: 10.1016/j.cmi.2018.03.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 02/26/2018] [Accepted: 03/04/2018] [Indexed: 10/17/2022]
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13
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Meriglier E, Roblot P, Landron C. Manifestations cutanées de la tularémie. Med Mal Infect 2018; 48:145-147. [DOI: 10.1016/j.medmal.2017.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 08/29/2017] [Accepted: 10/13/2017] [Indexed: 10/18/2022]
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Abstract
BACKGROUND Acute Q fever is asymptomatic in 60% of the patients, while the reminder may present with fever, pneumoniae, and hepatitis. Skin manifestations are uncommon including transient punctiform rashes, purpuric, or maculopapular eruptions. Erythema nodosum have seldom been reported. CASE PRESENTATION A 37-year-old female presented with fever for 1 month and skin lesions consists of erythematous painful nodule of the legs. Serological testing for Coxiella burnetii was positive. Treatment consisted with doxycycline for 2 weeks. Evolution was favorable. The patient completely recovered and had no evidence of skin lesion 1 month later. CONCLUSION Because of its nonspecific clinical presentation, Q fever with erythema nodosum is probably underestimated. Q fever should be evocated when facing unexplained erythema nodosum even if there is not other typical clinical manifestation of Q fever.
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Affiliation(s)
- E Meriglier
- Department of Internal Medicine, Centre hospitalier universitaire de Poitiers, 2 Rue de la milétrie, 86000, Poitiers, France. .,Department of infectious diseases, Centre hospitalier universitaire de Poitiers, 2 Rue de la milétrie, 86000, Poitiers, France.
| | - L Asquier
- Emergency unit, Centre hospitalier de La Rochelle, Rue du Dr Schweitzer, 17000, La Rochelle, France
| | - F Roblot
- Department of infectious diseases, Centre hospitalier universitaire de Poitiers, 2 Rue de la milétrie, 86000, Poitiers, France
| | - P Roblot
- Department of Internal Medicine, Centre hospitalier universitaire de Poitiers, 2 Rue de la milétrie, 86000, Poitiers, France
| | - C Landron
- Department of Internal Medicine, Centre hospitalier universitaire de Poitiers, 2 Rue de la milétrie, 86000, Poitiers, France
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Arrivé F, Roncato-Saberan M, Beuvon C, Martellosio JP, Meriglier E. [Tracheotomy for laryngeal tuberculosis]. Med Mal Infect 2017; 47:174-175. [PMID: 28215824 DOI: 10.1016/j.medmal.2017.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 01/18/2017] [Indexed: 10/20/2022]
Affiliation(s)
- F Arrivé
- Service de médecine interne, CHU de Poitiers, 2, rue de la Milétrie, 86000 Poitiers, France.
| | - M Roncato-Saberan
- Service de médecine interne/maladies infectieuses, CH La Rochelle, rue du Dr-Albert-Schweitzer, 17000 La Rochelle, France.
| | - C Beuvon
- Service de médecine interne, CHU de Poitiers, 2, rue de la Milétrie, 86000 Poitiers, France.
| | - J-P Martellosio
- Service de médecine interne, CHU de Poitiers, 2, rue de la Milétrie, 86000 Poitiers, France.
| | - E Meriglier
- Service de médecine interne, CHU de Poitiers, 2, rue de la Milétrie, 86000 Poitiers, France.
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16
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Meriglier E, Puyade M, Carretier M, Roblot F, Roblot P. [Long-term infectious risks after splenectomy: A retrospective cohort study with up to 10 years follow-up]. Rev Med Interne 2017; 38:436-443. [PMID: 28190612 DOI: 10.1016/j.revmed.2016.12.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 10/16/2016] [Accepted: 12/30/2016] [Indexed: 01/28/2023]
Abstract
INTRODUCTION Although most infections occur within the first 2 years after splenectomy, the relatively short follow-up reported in many studies may underestimate the frequency of infections. The objective of the study was to determine the incidence of infective outcomes and factors associated with infection after splenectomy by studying a group of patients who underwent splenectomy over a 10-year period. METHODS A retrospective and monocentric study of patients who underwent splenectomy between January 1st, 1997 and December 31st, 2004 in a French university hospital. Age, sex, indication for splenectomy, infectious events, death, vaccination and antibiotic prophylaxis were collected in January 2015. RESULTS One hundred and sixty-five patients were included. The most common reasons for splenectomy were therapeutic hematological indications (37.5%). Ninety-seven per cent received pneumococcal vaccine. Prophylactic antibiotics were prescribed in 78% of patients. Thirty-seven patients had 42 severe infections with a median incidence rate of 4 years after splenectomy (2 days-12 years). The rate of infection after splenectomy declined over time but 57% occurred after 2 years and 14.3% after 10 years. Respiratory infections were the most common sites of infections. The incidence of infection differed according to age was highest among the elderly (HR=6.2; 95%CI: 1.4-27.1; after 65 years old) and underlying reason for splenectomy (P=0.02). There is no difference with or without prophylactic antibiotics. CONCLUSION After splenectomy, the incidence of severe infection declined over time but can occur after 10 years. The onset of infection is linked to age and reason for splenectomy.
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Affiliation(s)
- E Meriglier
- Service de médecine interne, centre hospitalier universitaire de Poitiers, 2, rue de la Milétrie, 86021 Poitiers, France.
| | - M Puyade
- Service de médecine interne, centre hospitalier universitaire de Poitiers, 2, rue de la Milétrie, 86021 Poitiers, France
| | - M Carretier
- Service de chirurgie viscérale, centre hospitalier universitaire de Poitiers, Poitiers, France
| | - F Roblot
- Service de maladies infectieuses et tropicales, centre hospitalier universitaire Poitiers, Poitiers, France
| | - P Roblot
- Service de médecine interne, centre hospitalier universitaire de Poitiers, 2, rue de la Milétrie, 86021 Poitiers, France
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Meriglier E, Belhadj Chaidi R, Debouverie O, Luca L, Roblot P. [Breast lesions as the presenting feature of giant cell arteritis]. Rev Med Interne 2016; 37:561-3. [PMID: 27289543 DOI: 10.1016/j.revmed.2015.09.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 08/07/2015] [Accepted: 09/15/2015] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Giant cell arteritis most commonly involves the external carotid branches. Although they are less typical, extra-cephalic forms have also been reported. CASE REPORT We report the case of a 59-year-old female patient who developed bilateral, painful breast nodules with fever and altered general status since two months. Two weeks later, she presented frontal headache and scalp tenderness. A colour duplex ultrasound of the temporal artery showed a halo sign. The results of a breast needle biopsy were inconclusive but the temporal artery biopsy confirmed the diagnosis of giant cell arteritis. The disease course was rapidly favourable after institution of corticosteroids. INTRODUCTION Breast involvement is rare but could be the first sign of giant cell arteritis. The internal mammary artery, which is a branch of the subclavian artery, can be affected and responsible for breast nodules.
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Affiliation(s)
- E Meriglier
- Service de médecine interne, centre hospitalier universitaire de Poitiers, 2, rue de la Milétrie, 86000 Poitiers, France.
| | - R Belhadj Chaidi
- Service de médecine interne, centre hospitalier universitaire de Poitiers, 2, rue de la Milétrie, 86000 Poitiers, France
| | - O Debouverie
- Service de médecine interne, centre hospitalier universitaire de Poitiers, 2, rue de la Milétrie, 86000 Poitiers, France
| | - L Luca
- Service de médecine interne, centre hospitalier universitaire de Poitiers, 2, rue de la Milétrie, 86000 Poitiers, France
| | - P Roblot
- Service de médecine interne, centre hospitalier universitaire de Poitiers, 2, rue de la Milétrie, 86000 Poitiers, France
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Beuvon C, Meriglier E, Bachelet-Rousseau C, Roblot P, Roy-Peaud F, Martellosio J, Landron C. Glomérulonéphrite à lésions glomérulaires minimes : un cas rare qui a du Still. Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.04.148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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19
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Beuvon C, Meriglier E, Arrivé F, Pourreau F, Croquette M, Leroy F. Une vascularite à ANCA révélant deux néoplasies pulmonaires : à propos d’un cas. Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.04.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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20
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Meriglier E, Puyade M, Roblot P. PADS 1-08 - Complications infectieuses au delà de 10 ans chez les patients splénectomisés. Med Mal Infect 2016. [DOI: 10.1016/s0399-077x(16)30479-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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21
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Meriglier E, Puyade M, Cazenave-Roblot F, Roblot P. Complications infectieuses à long terme des patients splénectomisés : cohorte rétrospective avec un suivi de plus de 10ans. Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.04.276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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22
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Meriglier E, Debouverie O, Walter-Lepage A, Brigaud A, Beuvon C, Luca L. [Primary Sjögren's syndrome revealing cerebellar syndrome]. Rev Neurol (Paris) 2015; 171:674-6. [PMID: 25912281 DOI: 10.1016/j.neurol.2015.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 02/23/2015] [Accepted: 03/02/2015] [Indexed: 11/30/2022]
Affiliation(s)
- E Meriglier
- Service de médecine interne, CHU de Poitiers, 2, rue de la Milétrie, 86021 Poitiers, France.
| | - O Debouverie
- Service de médecine interne, CHU de Poitiers, 2, rue de la Milétrie, 86021 Poitiers, France
| | - A Walter-Lepage
- Service de médecine interne, CHU de Poitiers, 2, rue de la Milétrie, 86021 Poitiers, France
| | - A Brigaud
- Service de médecine interne, CHU de Poitiers, 2, rue de la Milétrie, 86021 Poitiers, France
| | - C Beuvon
- Service de médecine interne, CHU de Poitiers, 2, rue de la Milétrie, 86021 Poitiers, France
| | - L Luca
- Service de médecine interne, CHU de Poitiers, 2, rue de la Milétrie, 86021 Poitiers, France
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Meriglier E, Fritz O. [Cervical spine mass due to beta-2-microglobulin amyloidosis in a long-term hemodialysed patient]. Presse Med 2015; 44:966-8. [PMID: 26049905 DOI: 10.1016/j.lpm.2015.04.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2014] [Revised: 03/16/2015] [Accepted: 04/30/2015] [Indexed: 11/25/2022] Open
Affiliation(s)
- Etienne Meriglier
- CHU Poitiers, service de médecine interne, 2, rue de la Milétrie, 86000 Poitiers, France.
| | - Olivier Fritz
- Centre hospitalier La Rochelle, service de néphrologie, rue du Docteur-Schweitzer, 17000 La Rochelle, France
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Meriglier E, Puyade M, Cateau E, Maillard N. [Nodular skin lesions revealing fusariosis in a severe aplastic anemia patient]. Presse Med 2014; 44:574-6. [PMID: 25535158 DOI: 10.1016/j.lpm.2014.08.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Revised: 06/19/2014] [Accepted: 08/25/2014] [Indexed: 11/15/2022] Open
Affiliation(s)
- Etienne Meriglier
- CHU de Poitiers, service de médecine interne, 86000 Poitiers, France.
| | - Mathieu Puyade
- CHU de Poitiers, service d'onco-hématologie, 86000 Poitiers, France
| | - Estelle Cateau
- CHU de Poitiers, laboratoire de parasitologie, 86000 Poitiers, France
| | - Natacha Maillard
- CHU de Poitiers, service d'onco-hématologie, 86000 Poitiers, France
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Lepage A, Couderc E, Meriglier E, Guillet G. Nodules de la langue révélant une amylose AL associée à un myélome à chaînes légères lambda. Ann Dermatol Venereol 2014. [DOI: 10.1016/j.annder.2014.09.529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Meriglier E, Debouverie O, Walter A, Brigaud A, Luca L, Roblot P. Atteinte mammaire révélant une maladie de Horton : à propos d’un cas. Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.10.248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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27
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Meriglier E, Le Mao G, Bachelet-Rousseau C, Fritz O. Tumeurs brunes multiples chez deux patients hémodialysés. Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.10.133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Meriglier E, Roblot P, Fritz O, Le Mao G, Bachelet-Rousseau C, Leroy F. [Multiple costal lesions in a hemodialysis patient]. Rev Med Interne 2013; 35:405-6. [PMID: 24074967 DOI: 10.1016/j.revmed.2013.08.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Accepted: 08/19/2013] [Indexed: 10/26/2022]
Affiliation(s)
- E Meriglier
- Service de médecine interne, CHU de Poitiers, 2, rue de la Milétrie, 86021 Poitiers, France.
| | - P Roblot
- Service de médecine interne, CHU de Poitiers, 2, rue de la Milétrie, 86021 Poitiers, France
| | - O Fritz
- Service de néphrologie, groupe hospitalier de La-Rochelle-Ré-Aunis, rue du Docteur-Schweitzer, 17019 La-Rochelle cedex, France
| | - G Le Mao
- Service de néphrologie, groupe hospitalier de La-Rochelle-Ré-Aunis, rue du Docteur-Schweitzer, 17019 La-Rochelle cedex, France
| | - C Bachelet-Rousseau
- Service de néphrologie, groupe hospitalier de La-Rochelle-Ré-Aunis, rue du Docteur-Schweitzer, 17019 La-Rochelle cedex, France
| | - F Leroy
- Service de néphrologie, groupe hospitalier de La-Rochelle-Ré-Aunis, rue du Docteur-Schweitzer, 17019 La-Rochelle cedex, France
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Meriglier E, Lauda M, Luca L, Ramassamy A, Roblot P, Chagneau-Desbordes C. Hépatite E : un cas révélé sous immunosuppresseur. Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Meriglier E, Parrod E, Papet T, Arcade AL, Bironneau V, Gilbert M, Marais P. La transformation gélatineuse de la moelle : un cas rare de pancytopénie chez une patiente anorexique. Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.03.156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Meriglier E, Fritz O, Lemao G, Bachelet-Rousseau C. Amylose à B2-microglobuline : un cas rare qui saute au cou. Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.03.148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Meriglier E, Fritz O, Le Mao G, Bachelet-Rousseau C, Leroy F. Amylose AA : faut pas pousser le bouchon ! Rev Med Interne 2012. [DOI: 10.1016/j.revmed.2012.10.337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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