S Houzé

Assistance Publique – Hôpitaux de Paris, Lutetia Parisorum, Île-de-France, France

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Publications (14)40.39 Total impact

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    ABSTRACT: Toxoplasma gondii est responsable d’infections graves après transmission maternofœtale ou chez les sujets immunodéprimés. Plus rarement, des formes sévères avec atteinte viscérale au décours d’une primo-infection toxoplasmique ont été décrites chez le sujet immunocompétent notamment en Guyane Française. Nous rapportons le cas d’un adulte non-VIH et non greffé qui a présenté en France un tableau infectieux sévère non spécifique avec atteinte pulmonaire et cérébroméningée. Le diagnostic de toxoplasmose disséminée a été posé sur un résultat de PCR spécifique de T. gondii positif dans le LCR. La primo-infection a été confirmée par la sérologie. L’histoire de la maladie a été reconstituée à partir des résultats obtenus rétrospectivement par PCR en temps réel sur des sérums et des lavages broncho-alvéolaires. La recherche d’un déficit immunitaire suspecté devant les antécédents médicaux du patient était négative à ce jour. L’évolution a été favorable sous traitement antitoxoplasmique spécifique.
    Médecine et Maladies Infectieuses 02/2010; 40(10):596-9. · 0.75 Impact Factor
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    ABSTRACT: Toxoplasma gondii can be responsible for congenital toxoplasmosis leading to mild or severe sequelae, and for life-threatening infections in immunocompromised hosts. A new 5'-nuclease real-time PCR assay that targets the 300-fold repeated AF146527 DNA sequence (TaqMan-AF-PCR) has been developed and its performance for diagnosis of toxoplasmosis and treatment follow-up has been assessed. A retrospective analysis was first performed with 144 clinical specimens previously analysed for the presence of T. gondii DNA by a PCR-ELISA assay that targets the B1 gene of T. gondii (B1-PCR-ELISA). Fifteen samples, all from patients with clinically proven toxoplasmosis, were negative according to B1-PCR-ELISA and positive according to TaqMan-AF-PCR. A prospective analysis was then performed with 203 consecutive clinical specimens received at the laboratory of Parasitology of Saint-Louis Hospital during a 4-month period. The diagnosis of toxoplasmosis in two patients was made according to the TaqMan-AF-PCR whereas the B1-PCR-ELISA failed to make diagnosis. Additionally, iterative samples from a patient with cerebral and disseminated toxoplasmosis, already tested using a B1 real-time PCR assay, were tested using the TaqMan-AF-PCR and a Light Cycler real-time PCR assay targeting the same repetitive AF146527 sequence (LC-AF-PCR). Detection was achieved with the TaqMan-AF-PCR, with a mean gain of 7.1 and 3.3 amplification cycles when compared with the B1 real-time PCR and the LC-AF-PCR, respectively. This study demonstrates the higher sensitivity of the 5'-nuclease real-time PCR assay developed for the AF146527 DNA sequence and confirms the interest of using this highly repeated target to improve the diagnosis of toxoplasmosis.
    Clinical Microbiology and Infection 07/2009; 16(4):363-8. · 4.58 Impact Factor
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    ABSTRACT: A French nurse presented Plasmodium falciparum malaria 10 d after a needlestick while sampling blood in a source patient with malaria. As did the source patient, the nurse recovered fully although diagnosis was delayed and her malaria severe. We proceeded to a thorough description of the transmission profile of P. falciparum following occupational needlestick. A review of the literature found 21 published reports of occupational malaria including our own, documenting 22 P. falciparum infections. One of these was lethal. The mean incubation time to fever onset was documented in 21 reports including our own and is 11.60 +/- 3.38 d (median 12.0, range 4-17 d). The incubation period was compatible to that found in experimental anopheline bites or transfusion malaria. The transmission profile cites a pathogen which may be more easily transmissible by occupational exposure to blood than human immunodeficiency virus (HIV) or hepatitis C virus (HCV). Undiagnosed malaria in non-immune health care workers can be lethal. Presumptive treatment of malaria is widely available and well tolerated. Clinicians should consider P. falciparum malaria when faced with a febrile patient who has or may have been exposed to biological fluids. Further research is needed in the field of P. falciparum prophylaxis following accidental exposure to a malaria patient's blood.
    Scandinavian Journal of Infectious Diseases 02/2005; 37(2):131-40. · 1.71 Impact Factor
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    Emerging infectious diseases 11/2004; 10(10):1878-80. · 5.99 Impact Factor
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    Bull Epidemiol Hebdo. 02/2003;
  • La Revue de Médecine Interne 07/2001; 22 Suppl 2:219s-222s. · 0.90 Impact Factor
  • Revue De Medecine Interne - REV MED INTERNE. 01/2001; 22:219-222.
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    ABSTRACT: The purpose of this prospective study was to update epidemiological data on cutaneous larva migrans (CLM) and to assess the therapeutic efficacy of ivermectin. We performed the study between June 1994 and December 1998 at our travel clinic. Ivermectin (a single dose of 200 microg/kg) was offered to all the patients with CLM, and its efficacy and tolerability were assessed by a questionnaire. Sixty-four patients were enrolled. All were European and had stayed in tropical areas. After the patients had returned from their destinations, 55% had lesions occur within a mean of 16 days (range, 1-120 days; >1 month in 7 patients). The initial diagnosis was wrong in 55% of patients. The mean number of lesions was 3 (range, 1-15), and the main sites were the feet (48%) and buttocks (23%). The cure rate after a single dose of ivermectin was 77%. In 14 patients, 1 or 2 supplementary doses were necessary, and the overall cure rate was 97%. The median time required for pruritus and lesions to disappear was 3 and 7 days, respectively. No systemic adverse effects were reported. Physicians' knowledge of CLM, which can have a long incubation period, is poor. Single-dose ivermectin therapy appears to be effective and well tolerated, even if several treatments are sometimes necessary.
    Clinical Infectious Diseases 08/2000; 31(2):493-8. · 9.37 Impact Factor
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    ABSTRACT: We have developed two diagnostic assays based on the specific detection of Plasmodium lactate dehydrogenase (pLDH) activity. These assays exploit a panel of monoclonal antibodies that capture the parasite enzyme and allow for the quantitation and speciation of human malaria infections. An immunocapture pLDH activity assay (ICpLDH) allows for the rapid purification and measurement of pLDH from infected blood using the NAD analog APAD, which reacts specifically with Plasmodium LDH isoforms. An immunochromatographic test (the OptiMAL assay) was also formatted and allowed the detection of parasite infections of approximately 200 parasites/microl of blood. By using a combination of antibodies, both tests can not only detect but differentiate between P. falciparum and non-P. falciparum malaria. Both assays show a sensitivity comparable with other commercial nonmicroscopic tests; importantly, we found very few instances of false-positive samples, especially with samples from patients recently cleared of malaria infection. Furthermore, we find that when one uses the quantitative ICpLDH assay, the levels of pLDH activity closely mirror the levels of parasitemia in both initial diagnosis and while following patient therapy. We conclude that diagnostic tests based on the detection of pLDH are both sensitive and practical for the detection, speciation, and quantitation of all human Plasmodium infections and can also be used to indicate drug-resistant infections.
    The American journal of tropical medicine and hygiene 02/1999; 60(1):109-18. · 2.53 Impact Factor
  • Parasite 01/1997; 3(4):391-3. · 0.82 Impact Factor
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    ABSTRACT: An outbreak of trichinosis caused by ingestion of horse meat occurred in December 1993 in France; more than 500 people were affected. We compared the immediate and midterm efficacy and tolerability of thiabendazole and albendazole as therapy for the 46 patients seen in our department. Forty-four patients (96%) were treated. The first 26 patients received thiabendazole therapy; the next 18 received albendazole therapy. All the patients were tested with prednisone. Eight relapses occurred (seven in the thiabendazole group and one in the albendazole group [not significant]). Side effects of treatment were reported by seven patients, all of whom were treated with thiabendazole (P = .01). Six months after treatment, 16 of the 31 patients who responded to a questionnaire still had symptoms, the most frequent of which were myalgias (81%) and fatigue (69%). No significant difference was observed between the two treatment groups. The immediate efficacy of thiabendazole and albendazole as therapy for trichinosis was comparable, but albendazole was better tolerated.
    Clinical Infectious Diseases 07/1996; 22(6):1033-5. · 9.37 Impact Factor
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    ABSTRACT: Detection of microsporidia belongs to the usual coprologic and urine detection of parasites from HIV seropositive patients. To improve the identification of microsporidial spores, several stains have been used. Trichrome Blue stain has been evaluated in this study. We first compared Trichrome Blue stain to Weber's trichrome for the detection of microsporidia in smears of stools received from HIV seropositive patients. No difference of sensibility has been demonstrated between the two stains, and Uvitex 2B used on the same samples has confirmed these results. Then, Trichrome Blue stain has been used for the detection of microsporidial spores in other specimens (40 samples of nasal mucus, conjonctival samples, duodenal biopsy and urine), also Giemsa and Uvitex 2B. The advantage of Trichrome Blue stain is its ready-to-use presentation, and faster realisation at higher temperature. Trichrome Blue stain is interesting as a confirmation technique or for laboratories which do not have fluorescent microscopy equipment.
    Bulletin de la Société de pathologie exotique 02/1996; 89(3):179-80.
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    ABSTRACT: An increase in parasitaemia is not uncommon after initiation of treatment for Plasmodium falciparum malaria, but its exact significance is unknown. The time-course of parasitaemia was assessed retrospectively in 33 patients with severe imported malaria. In 19 patients (group 1) mean parasitaemia (+/- SEM) fell promptly after starting quinine treatment, from 24.9 +/- 4.1% on day 0 to 9.7 +/- 2.3% on day 1 and 1.8 +/- 0.7% on day 2. In 14 other patients (group 2), parasitaemia did not change significantly or increased, with mean parasitaemia (+/- SEM) of 9.5 +/- 2.1% on day 0, 17.2 +/- 2.6% on day 1, and 3.7 +/- 1.8% on day 2. Simplified acute physiology scores on admission (mean +/- SEM) were 17.4 +/- 1.4 in group 1 and 11.7 +/- 1.0 in group 2 (P = 0.006). The mean number of complications of malaria per patient (+/- SEM) was 2.9 +/- 0.5 in group 1 and 1.6 +/- 0.3 in group 2 (P = 0.046). Two group 1 patients died. Initially, more than 95% of peripheral blood parasites were tiny and small rings in both groups, and this distribution was unchanged on day 1, suggesting that the parasitaemia increase in group 2 was not due to release of sequestered mature parasites. In severe falciparum malaria, a rise in parasitaemia after treatment initiation may be of favourable prognostic significance and should not lead to aggressive therapeutic approaches such as exchange transfusion.
    Transactions of the Royal Society of Tropical Medicine and Hygiene 01/1996; 90(4):388-90. · 1.82 Impact Factor
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    ABSTRACT: The Parasight-F test based on the detection of a soluble antigen specific for Plasmodium falciparum is designed for the immediate diagnosis of malaria infection. We evaluated its use by clinicians during consultations. This prospective study of its diagnostic utility in febrile patients consulting a travel clinic on their return from areas endemic for malaria was conducted between May 1996 and May 1997. The Parasight-F test was performed by the clinician with confirmation by means of standard microscopic examination of venous blood. One-hundred and forty patients were enrolled. Forty-three (31%) cases of malaria were identified by microscopic examination. Thirty-eight were due to P. falciparum. The Parasight-F tests yielded 6 false-positive and 3 false-negative results compared to the microscopic findings. The specificity and sensitivity for the diagnosis of P. falciparum malaria were 94% and 92%. These results show that the Parasight-F test alone cannot replace microscopic diagnosis of malaria in travel clinics.
    The American journal of tropical medicine and hygiene 63(1-2):76-9. · 2.53 Impact Factor