E Denes

Publications (21)32.9 Total impact

• Article: Voriconazole stability in cement spacers.

  E Denes, F Fiorenza, F Saint-Marcoux, M Megherbi, M Dupon, P Weinbreck
  Médecine et Maladies Infectieuses 10/2012; · 0.72 Impact Factor
• Article: Antibiotic prescription by general practitioners for urinary tract infections in outpatients.

  E Denes, J Prouzergue, S Ducroix-Roubertou, C Aupetit, P Weinbreck
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  ABSTRACT: In July 2008, in France, guidelines for antibiotic prescriptions for urinary tract infections (UTIs) were amended. As general practitioners (GPs) treat numerous UTIs, we wanted to evaluate whether they followed these guidelines. In order to do this, we performed a prospective study. The point of call was urinalyses. Using this selection method together with criteria diagnostic for urinalysis, we confirmed that patients presented a UTI. Each GP was contacted. Prescriptions were analysed and compared to the 2008 French guidelines for UTIs. Our study included 185 urinalyses. UTIs diagnosed by GPs were as follows: acute cystitis: 72.4 %, prostatitis: 13.5 %, nephritis: 8.7 % and asymptomatic bacteriuria: 5.4 %. The principal antibiotics used were: quinolone (59.5 %), furan (17.8 %) and cotrimoxazole (6.5 %). Only 20 % of the prescriptions were compliant with the guidelines. The correct antibiotic but not the dose or the duration of prescription was selected in 8.1 % of the prescriptions. For cystitis, inappropriate prescription was associated with an extra cost of 694 , namely, 7.4 per treatment. GP prescriptions for UTIs do not follow the guidelines. Even if GPs assert that they are aware of the emergence of resistant strains, it seems that they do not take into account the objective of quinolone restriction, which was one of the backbones of these guidelines.
  European Journal of Clinical Microbiology 06/2012; 31(11):3079-83. · 2.86 Impact Factor
• Source

  Available from: smw.ch

  Article: Intrathecal synthesis of specific antibodies as a marker of herpes simplex encephalitis in patients with negative PCR.

  Eric Denes, Catherine Labach, Hélène Durox, Thierry Adoukonou, Pierre Weinbreck, Laurent Magy, Sylvie Ranger-Rogez
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  ABSTRACT: PCR in the cerebrospinal fluid (CSF) has become the sole method used for the diagnosis of herpes simplex encephalitis (HSE). Nevertheless, PCR results may sometimes be false negative, and in this situation other techniques may be useful. 3 patients hospitalised for meningoencephalitis with fever showed a negative result for herpes simplex virus (HSV) PCR in their CSF. We then performed a detection of intrathecal anti-HSV immunoglobulins (IgGs) in the CSF and analysed their level in relation to those in the serum, compared to albumin. We confirmed that IgG synthesis was the direct consequence of an immune system reaction in the 3 patients' CSF. These results were consistent with clinical signs and neurodiagnostic procedures. They prompted us to continue the treatment, which would have been stopped following the negative PCR results. The clinical progression was favourable for all patients. PCR, which many physicians now consider the gold standard for the detection of HSV, may sometimes yield false negative results, i.e. when performed too early after the disease onset or when the viral load is too low. The method described here, although positive a few days after PCR, may prove helpful in the diagnosis of HSE for patients with negative HSV PCR in the CSF.
  Schweizerische medizinische Wochenschrift 01/2010; 140:w13107. · 1.68 Impact Factor
• Article: [Community-acquired meningitis due to methicillin susceptible Staphylococcus aureus].

  P Pinet, E Denes, F Garnier, H Durox, S Ducroix-Roubertou, P Weinbreck
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  ABSTRACT: Meningitis due to Staphylococcus aureus is infrequent. MRSA is mainly found after neurosurgery, but MSSA may be involved in community-acquired meningitis. However, this kind of infection is not widely reported, despite its severity. We describe the characteristics of five patients hospitalized in our ward over a period of 18 months who presented with community-acquired meningitis due to MSSA. The patients were three men and two women with a mean age of 62 years. One patient was immunosuppressed. Neurological signs were present at the onset for only two patients. In all cases, there were extraneurological localizations of the infection, mainly in bones (spondylodiscitis, epidural abscess, arthritis) but also lung infection. Three patients with meningeal inflammation also presented with confusion. CSF analysis revealed less than 950 white blood cells, hyper-CSF-proteins, and hypo-CSF-glucose. Bacteraemia was present in all patients. The source of infection was never determined. The evolution was good for all patients with a prolonged antibiotic course. The analysis of genetic determinants for three strains revealed the presence of TSST-1 which could account for the severity of the disease. Community-acquired MSSA meningitis is a serious infection, occurring in patients without risk factors. Hematogenous dissemination leads to multiple tissue infection. A long course of antibiotics, with high doses, is needed to treat meningitis but also extraneurological localizations. The role of TSST-1 needs to be confirmed in other patients.
  Médecine et Maladies Infectieuses 10/2009; 40(3):156-60. · 0.72 Impact Factor
• Article: Syphilitic periostitis.

  E Denes, P Pinet, S Ducroix-Roubertou, L Magy, P Vergne-Salle
  European Journal of Internal Medicine 06/2009; 20(3):e78-9. · 2.00 Impact Factor
• Article: [Disseminated aspergillosis after intra-articular corticosteroid infiltrations].

  H Durox, A Boumediene, C Genet, P Lo Ré, J-P Rogez, P Weinbreck, E Denes
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  ABSTRACT: Bone and joint infections due to Aspergillus are rare and occur more commonly in immunosuppressed patients. We report the case of an 84-year-old woman who developed septic arthritis caused by Aspergillus fumigatus after corticosteroid infiltration. This patient had presented with arthritis of the left knee for several months but no microorganism had been found despite numerous arthrocenteses. This arthritis was resistant to treatment by numerous corticosteroid infiltrations. During an arthroscopy, analysis of the synovial fluid yielded A. fumigatus. Thereafter, other explorations showed disseminated aspergillosis with osteo-articular destruction, blood and urinary dissemination. A systemic treatment by voriconazole associated to intra-articular injections and surgical debridement was initiated but the patient died. Septic arthritis caused by A. fumigatus is very rare but must be considered as a differential diagnosis of septic arthritis after corticosteroid infiltration. Their complications can be very important and destructive.
  Médecine et Maladies Infectieuses 10/2007; 37(9):609-12. · 0.72 Impact Factor
• Article: [Cutaneous drug reactions induced by glycopeptides].

  S Prey, A Sparsa, A Boumediene, J-M Bonnetblanc, P Weinbreck, E Denes
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  ABSTRACT: Glycopeptides are a class of antibiotics used with a rising frequency because of the increasing number of infections due to Methicillin-resistant staphylococci. The dermatological adverse effect of vancomycin are well-known: "red man syndrome", maculopapular exanthema, etc., with some distinctive features such as Ig A linear dermatosis. Drug eruptions are less common but not insignificant when using teicoplanin, a more recent molecule. A given glycopeptide cannot be considered as an alternative for every patient "allergic" to another, because of cases of cross-reaction and the morbi-mortality of some cutaneous drug reactions. This emphasizes the importance to recognize early clinical signs. In this article, we review the various dermatological adverse drug reactions induced by glycopeptides, and suggest a possible management to clinicians who could be confronted with this problem.
  Médecine et Maladies Infectieuses 06/2007; 37(5):270-4. · 0.72 Impact Factor
• Article: Voriconazole concentrations in synovial fluid and bone tissues.

  E Denes, A Boumediene, H Durox, A Oksman, F Saint-Marcoux, M-L Darde, J-M Gaulier
  Journal of Antimicrobial Chemotherapy 05/2007; 59(4):818-9. · 5.07 Impact Factor
• Article: [One episode of meningoencephalitis, three diagnoses].

  E Denes, H Durox, A Boumediene, B Champtiaux-Dechamp, A Dugard, S Ranger-Rogez, P Couratier
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  ABSTRACT: Meningo-encephalitis is a set of threatening diseases. The treatment needs to be started quickly for pathogens such as herpes simplex virus type 1 or Listeria monocytogenes. Apart from these classical etiologies, many other diseases may induce meningo-encephalitis. We report the case of a patient, infected with HIV, who presented a history of meningo-encephalitis due to herpes simplex type 1. Three weeks later, he presented an encephalopathy due to aciclovir and then we discovered a chronic meningitis in relation with his HIV infection.
  Revue Neurologique 04/2007; 163(3):369-72. · 0.49 Impact Factor
• Article: [Do HIV patients know their treatment?].

  E Denes, J-P Rogez, P Weinbreck
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  ABSTRACT: Optimal adherence to antiretroviral therapy (ART) in HIV disease is one of the key factors for its efficacy. The authors had for aim to assess HIV infected patients' knowing of their ART and the correlation with a controlled HIV viral load. We conducted a transversal study. Outpatients were asked at the beginning of a consultation to give the name, the dosage, and the color of their medication. 93 patients were included with a mean age of 45.6 years. 25.8% were AIDS patients and 82.8% had an HIV viral load under 50 copies/ml. The mean duration of treatment was 6.23 years and the latest treatment had been given for 2.26 years. They took an average of 2.6 different drugs and 5.4 pills per day. 22.6% used a pillbox. 90.3% of the patients bought their treatment by themselves and 86% prepared it. The name of all the drugs was known in 68.8%, doses in 90.3%, and colors in 83.9%. In univariate as in multivariate analysis, the use of a pillbox improves the knowledge of the dose (P = 0.01). AIDS patients know the names better (P = 0.02). In univariate and multivariate analysis, knowledge of dosage was correlated to a controlled viral load (P = 0.04). HIV patients know their treatment well and the knowledge of the dose could be a marker of adherence to ART as it is associated with a controlled viral load.
  Médecine et Maladies Infectieuses 08/2006; 36(7):375-8. · 0.72 Impact Factor
• Article: [Post-menopausal endometrial tuberculosis].

  C Genet, S Ducroix-Roubertou, G Gondran, H Bezanahary, P Weinbreck, E Denes
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  ABSTRACT: A 69-year-old menopaused woman, presented a 2-month history of metrorrhagia. We suspected a malignant disease, but, the histopathologic examination of biopsies, found an endometrial inflammation without malignant cells. Culture for mycobacteria showed a Mycobacterium tuberculosis. A course of four-drug antituberculous therapy was started and the patient recovered. Tuberculosis remains a common disease, but genital infection is infrequent. Usually, it concerns young infertile women from non-industrial countries. More attention should be paid to this disease. Women, irrespective of their age, should be investigated for silent or subclinical genital symptoms, with mycobacterial examination.
  Journal de Gynécologie Obstétrique et Biologie de la Reproduction 03/2006; 35(1):71-3. · 0.42 Impact Factor
• Article: [Salmonella of Indian origin: pseudo-susceptibility to fluoroquinolones].

  E Denes, G Gondran, H Bezanahary, C Genet, J P Rogez, P Weinbreck, C Martin
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  ABSTRACT: We report the case of a patient presenting with typhoid fever after returning from a stay in India. This infection was not cured with a course of ciprofloxacin, due to a reduced susceptibility of the bacteria to the drug. This decreased susceptibility to fluoroquinolones was not detected by the antibiogram, but the MIC for nalidixic acid was greater than 32 mg/l. This case suggests using a third generation cephalosporin instead of a quinolone, for people coming from a high-risk zone. It also suggests that the MIC for nalidixic acid and for norfloxacin can be used as the first clue for a reduced susceptibility to fluoroquinolones.
  Médecine et Maladies Infectieuses 05/2005; 35(4):223-4. · 0.72 Impact Factor
• Source

  Available from: oxfordjournals.org

  Article: Pharmacokinetics of voriconazole in the cerebrospinal fluid of an immunocompromised patient with a brain abscess due to Aspergillus fumigatus.

  E Denes, N Pichon, M Debette-Gratien, B Bouteille, J M Gaulier
  Clinical Infectious Diseases 09/2004; 39(4):603-4. · 9.15 Impact Factor
• Article: [Mycobacterium szulgai arthritis in an HIV patient during immune reconstitution].

  C Genet, E Denes, J P Rogez, J A Gandji, C Martin, P Weinbreck
  Médecine et Maladies Infectieuses 06/2004; 34(5):229-30. · 0.72 Impact Factor
• Article: [Isolated neurosarcoidosis without systemic signs].

  L Kort, M-P Boncoeur, M Delage-Corre, A Moufid, E Denes, P Couratier
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  ABSTRACT: Sarcoidosis is a multisystemic disease which involves the nervous system in 5 to 15 p.cent. Neurosarcoidosis without signs of systemic disease is rare and may be difficult to diagnose. We report a case of a 61 year-old patient with a pseudotumoral neurosarcoidosis and along evolution of 25 years without systemic signs. In such cases, histological analysis is rewarding.
  Revue Neurologique 05/2003; 159(4):455-7. · 0.49 Impact Factor
• Article: [A case of cervical calcinosis].

  E Denes, V Gissot, M Arnaud, J L Pascaud, V Loustaud, E Vidal
  La Revue de Médecine Interne 12/2000; 21(11):1001-2. · 0.61 Impact Factor
• Article: [Cutaneous reactions or necrosis from interferon alpha: can interferon be reintroduced after healing? Six case reports].

  A Sparsa, V Loustaud-Ratti, E Liozon, E Denes, P Soria, M L Bouyssou-Gauthier, V Le Brun, S Boulinguez, C Bédane, M Scribbe-Outtas, O Outtas, F Labrousse, J M Bonnetblanc, D Bordessoule, E Vidal
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  ABSTRACT: Alpha, beta or gamma interferon (INF) are cytokines produced by cells in response to antigenic stimulation. They are used to treat various hepatic, hematological, oncological and neurological diseases. Cutaneous reactions (rash, alopecia, labial herpes, erythema, or induration at the site of injection, and more rarely cutaneous necrosis) represent 5 to 12% of side-effects observed in patients receiving INF. The authors report six cases of local cutaneous reactions to alpha INF, five of which corresponded to cutaneous necrosis. This makes them question the relevance of INF reintroduction. The study included 5 male and 1 female patients (mean age: 59.1 years; range: 42 to 74 years old). Three patients had chronic hepatitis C, while three others presented a blood disease. Cutaneous necrosis occurred after 1 to 10 months of treatment. The mean time to healing was 16.2 weeks. Reintroduction of the drug including injection in other sites did not lead to recurrence of necrosis in five out of the six cases. INF-induced cutaneous necrosis does not depend on the type of INF, the site of injection, the dose and may occur 2 months to 9 years after treatment implementation. The exact mechanisms involved in cutaneous necrosis remain unknown. Morbidity is due to a very long time to healing (4 to 6 months). Futhermore, healing sometimes requires prior surgery. Physicians should be aware of the potential occurrence of erythema in patients treated by INF, as it is the first sign of necrosis. The site of injection should then be modified. In case of necrosis, risk factors for thrombophilia, factors reducing microcirculation (DHE, beta-blockers, cigarette smoking) should be investigated. INF injections should be cautiously reintroduced in other sites with the help of a nurse in case of self-injections prior to the occurrence of necrosis. Regarding self-injections patients' training should be emphasized.
  La Revue de Médecine Interne 10/2000; 21(9):756-63. · 0.61 Impact Factor
• Article: Management of Babesia divergens babesiosis without a complete course of quinine treatment.

  E Denes, J P Rogez, M L Dardé, P Weinbreck
  European Journal of Clinical Microbiology 10/1999; 18(9):672-3. · 2.86 Impact Factor
• Article: [Reactive arthritis due to Clostridium difficile].

  S Ducroix-Roubertou, C Genet, J P Rogez, P Weinbreck, E Denes
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  ABSTRACT: Extracolonic manifestations of Clostridium difficile infections have rarely been reported as a cause of reactive arthritis. We report the case of a monoarticular arthritis following pseudomembranous colitis. A 45 year-old man was admitted for fever and monoarthritis of the left knee, 8 days after the onset of a C. difficile enterocolitis associated with urethritis. Samples obtained from the knee, urine, and blood cultures remained sterile. Bone scintigraphy revealed a left knee and forefoot hyperfixations. The association of arthritis and urethritis led us to the diagnosis of Fiessinger-Leroy-Reiter syndrome. Antibiotics for arthritis were ineffective and stopped, but they were continued for colitis. NSAIDs were prescribed and clinical manifestations disappeared within 24 hours, the patient resumed walking after 48 hours. Four months later there was no relapse and no sequela.
  Médecine et Maladies Infectieuses 35(7-8):419-21. · 0.72 Impact Factor
• Article: [Antibiotherapy for acute CAP in adults].

  E Denes
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  ABSTRACT: Community acquired pneumonia is one of the most frequent infections. With time, bacterial epidemiology and bacterial resistance evolve and new antibiotics become available. So an up-date on adequate antibiotic use is necessary. We reviewed the epidemiology of pneumonia and the evolution of bacterial resistance. We also collected data on new antibiotics which can be used for this infection such as levofloxacin, moxifloxacin, telithromycin, and pristinamycin. All these drugs are effective on bacteria involved in pneumonia. At this time, only few Streptococcus pneumoniae strains have developed resistance to these drugs. However, resistance to fluoroquinolones is not easily detected with common laboratory techniques. There is no effectiveness difference between the 2 new fluoroquinolones (levofloxacin, moxifloxacin) in clinical studies. However, in bacteriological and pharmacological studies, moxifloxacin seems to be more effective than levofloxacin (500 mg/day). For the treatment of pneumonia due to Legionella pneumophila, fluoroquinolones are now widely recommended. For Streptococcus pneumonia, amoxicillin remain the drug of choice, even for bacteria with a decreased susceptibility to penicillin. The importance of treating atypical pathogens remains to be documented.
  Médecine et Maladies Infectieuses 36(11-12):718-33. · 0.72 Impact Factor