Philippe Leonard

• Centre Hospitalier Universitaire de Liège

Objectives The aim of this retrospective study was to collect epidemiological, clinical, laboratory, imaging, management, and follow-up data on cases of alveolar echinococcosis (AE) diagnosed and/or followed up within the Namur Hospital Network (NHN) in order to gather information on the challenges, pitfalls, and overall experience in the diagnosis...

Summary. Four new Pachnoda Burmeister, 1842 species from the Pachnoda helleri (Moser, 1910) complex are described. Pachnoda upembaensis Léonard & Bouyer, n. sp. from Parc national de l’Upemba in the Haut Lomami in Democratic Republic of Congo, Pachnoda lufiraensis Léonard & Bouyer, n. sp. from Lualaba and Haut-Katanga in Democratic Republic of Cong...

Progressive multifocal leukoencephalopathy (PML) is an opportunistic infectious demyelinating disease of the central nervous system caused by JC polyomavirus predominantly affecting immunocompromised individuals. Nowadays, HIV, hematological malignancies and iatrogenic immune suppression account for most PML cases. For unknown reasons, spinal cord...

We conducted morphological and DNA barcoding analyses of representative taxa in the Mecynorhina Hope, 1837 species-complex (type species: Scarabaeus polyphemus Fabricius, 1781), which had been split into five subgenera by DE PALMA & FRANTZ (2010). Subgenus Mecynorrhinella Marais and Holm, 1992 (type species: Mecynorhina oberthuri Fairmaire, 1903),...

Alveolar echinococcosis is an indigenouszoonosis caused by the growth of the larval stage of a small tapeworm, Echinococcus multilocularis. Despite a low incidence in Belgium, with about 10 cases on average recorded per year, this parasitosis poses a real public health problem because it often remains difficult to diagnose and is potentially fatal...

Morphological and DNA barcoding analysis of representative taxa in the Eudicella White complex identified five distinct subgenera, three of which are established herein: Eudicella (Coelorrhinella) n. subg., Eudicella (Aneurhina) n. subg., and Eudicella (Ceratorhinella) n. subg. The remaining taxa are either assigned to Eudicella s. str. or Eudicell...

Importance: Recent data suggest a relatively low incidence of COVID-19 among children. The possible role that children attending primary school may play in the transmission of SARS-CoV-2 remains poorly understood. Objective: To gain a better understanding of the possible role of children in the transmission of SARS-CoV-2. Design, setting, and p...

Background As cardiovascular diseases represent the main cause of non-AIDS related death in people living with HIV (PLWH) with undetectable viral load, we evaluated lipid profile, weight gain and calculated cardiovascular risk change after switching from tenofovir disoproxil fumarate (TDF)-based regimens to tenofovir alafenamide (TAF)-based regimen...

Objectives Various symptoms and considerable organ dysfunction persist following SARS-CoV-2 infection. Uncertainty remains about the potential mid- and long-term health sequelae. We prospectively studied patients hospitalized for COVID-19 in Liège University Hospital, Belgium, to determine the persistent consequences of Coronavirus disease 2019 (CO...

The authors report the case of a 41-year-old patient originating from Algeria who developed obstructive cholangitis caused by the membrane of a ruptured hydatid cyst leading to the diagnosis of cystic echinococcosis. Cystic echinococcosis can be asymptomatic for several years until a complication occurs, such as in this case an obstruction of the c...

Background Polypharmacy and drug interactions are important issues for HIV-infected individuals. The number and nature of those interactions are continuously evolving with the use of new antiretroviral drugs and the aging of HIV-infected individuals. We aimed to analyze this evolution over time. Methods This retrospective cohort study was conducte...

Malaria is a worldwide public health problem. In Europe, data show an increasing trend of imported cases in the last ten years. Following an alarming observation reporting resistance to anti-malarial drugs, new effective treatments have been developed in early 21st century. These are artemisinin and its derivatives. Artemisinin-based combination th...

Background: HIV persistence despite therapy contributes to chronic immune activation and inflammation, increasing the risk of aging-associated events in HIV-infected individuals. Objectives: To better understand the complex link between clinical and treatment features and HIV persistence despite therapy. Methods: 11045 samples from 1160 individuals...

We conducted barcoding analysis of valid taxa in the genus Goliathus Lamarck, 1802 and clarified their relationships. Specimens of Goliathus goliatus (Drury, 1770) sampled in tropical rainforests from Cameroon to Kenya display degrees of genetic and phenotypic separation that, however, do not seem to justify subspecific splitting. Goliathus meleagr...

Late presentation for HIV care is a major issue and the cause of higher morbidity, mortality and transmission. In this regard, we analyzed the characteristics of patients presenting for care at our center from January 2006 to July 2017 (n = 687). The majority of the studied population was of African origin (54.3%) with heterosexual women representi...

Alveolar echinococcosis is a zoonotic disease due to the tapeworm Echinococcus multilocularis. The definitive host is the red fox. Until recently, Belgium was considered a country at very low risk for alveolar echinococcosis. However, recent studies carried out in southern Belgium have revealed, through post-mortem examination, high prevalences (up...

Cystic echinococcosis or hydatidosis, is a zoonosis caused by larval stages of Echinococcus granulosus that can be encountered in Belgium in patients originating from endemic countries. The liver is the most commonly affected organ. In this paper, the authors describe the multidisciplinary management of this pathology based on the clinical case of...

Campylobacter coli is a major pathogen rarely responsible for extra-intestinal infections. We report a case of Campylobacter coli bacteremia and meningitis in a 57-year-old immunocompetent Belgian man. The strain, isolated from cerebrospinal fluid, belonged to the unusual sequence type 8418 (ST8418). The patient fully recovered after meropenem trea...

We present the case of an acute endocarditis of mitral and aortic prosthetic heart valves caused by Aggregatibacter aphrophilus (Haemophilus aphrophilus-paraphrophilus). This third report in the literature emphasizes the diagnostic work-up and the role of positron emission tomography combined with computed tomography in this setting. The specificit...

Background Leishmaniasis is a protozoan disease caused by parasites of the genus Leishmania, transmitted to humans by sandflies. The diagnosis of leishmaniasis is often challenging as it mimics many other infectious or malignant diseases. The disease can present in three ways: cutaneous, mucocutaneous, or visceral leishmaniasis, which rarely occur...

The Acquired ImmunoDeficiency Syndrome (AIDS) is a chronic infectious disease. By its complexity and the importance of psychiatric syndromes observed among HIV patients, the common contribution of somatic and psychiatric health specialists is often mandatory. Conversely, more or less 20 % of psychiatric patients are infected by the AIDS' virus. Mor...

Résumé. L’arbre des distances génétiques des trois espèces de Mecynorhina (Chelorhinella) est illustré. Il confirme le statut de bonne espèce de Mecynorhina (Chelorhinella) bouyeri Léonard & Beinhundner, 2014, Mecynorhina (Chelorhinella) romyae Léonard & Beinhundner, 2014 et Mecynorhina (Chelorhinella) savagei Harris, 1844. Summary. The tree of gen...

This study aimed at estimating, in a prospective scenario, the potential economic impact of a possible epidemic of WNV infection in Belgium, based on 2012 values for the equine and human health sectors, in order to increase preparedness and help decision-makers. Modelling of risk areas, based on the habitat suitable for Culex pipiens, the main vect...

We report a case of louse-borne relapsing fever (LBRF) in a refugee from Somalia who had arrived in Belgium a few days earlier. He complained of myalgia and secondarily presented fever. Blood smears revealed spirochetes later identified as Borrelia recurrentis . LBRF should be considered in countries hosting refugees, particularly those who transit...

A sero-epidemiological survey was organized among veterinarians working in Southern Belgium to estimate the seroprevalence of Q fever and the risk factors associated with exposure. A total of 108 veterinarians took part to this cross-sectional study, with a majority practicing with livestock animals. The overall seroprevalence was 45.4%, but it inc...

Background: Chronic kidney disease (CKD) is a major health issue for HIV-positive individuals, associated with increased morbidity and mortality. Development and implementation of a risk score model for CKD would allow comparison of the risks and benefits of adding potentially nephrotoxic antiretrovirals to a treatment regimen and would identify t...

Paecilomyces lilacinus is a ubiquitous saprophytic fungus that rarely causes infections in humans, frequently affecting the eyes and the skin. Cutaneous and subcutaneous infections mainly occur in immunocompromised hosts but have occasionally been reported in immunocompetent patients. The clinical spectrum is highly heterogeneous and diagnosis is o...

We describe here a case of spondylodiscitis of brucellosis origin in one patient back from Turkey. Some weeks later, her mother, who had accompagnied her in Turkey also developped similar symptoms. A diagnosis of spondylodiscitis due to a contamination by Brucella melitensis was also proposed. Since the control of animal brucellosis in Europe, huma...

Amoebiasis is a disease of parasitic origin responsible for dysentery and extra-intestinal complications. The infection is by Entamoeba histolytica, an amoeba whose geographical distribution is cosmopolitan, but that is more prevalent in tropical areas. Only a few infections are symptomatic and some of them may cause extra-intestinal complications....

: Platelet-rich plasma (PRP) contains a large number of growth factors, which may enhance tendon healing processes. Local injection of PRP represents a relatively new treatment for tendinopathies. To date, no side effects have been reported after injection of PRP to treat tendinopathy. We report a case of exuberant inflammatory reaction after 1 inj...

Background PRP, obtained from centrifuged autologous blood, contains a large quantity of growth factors, which may enhance tissue healing processes. Local infiltration of PRP represents a relatively new treatment for tendinopathies. To date, no side effects have been reported after infiltration of PRP to treat tendinopathy. ¹ Case report A 35-year...

We report the case of a 47 year old patient who had been suffering from persistent cough for more than three weeks. Patient coughed predominantly during night time, without fever. The amoxicillin-clavulanic acid initially prescribed was not effective. A series of complementary investigations were performed before serology finally identified Bordete...

OBJECTIVES: To investigate the mechanisms of platelet kinetics in the Strategies for Management of Antiretroviral Therapy (SMART) study that demonstrated excess mortality with CD4 guided episodic antiretroviral therapy (ART) drug conservation compared with continuous treatment viral suppression. Follow-up analyses of stored plasma samples demonstr...

To test the usefulness of procalcitonin serum level for the reduction of antibiotic consumption in intensive care unit patients. Single-center, prospective, randomized controlled study. Five intensive care units from a tertiary teaching hospital. All consecutive adult patients hospitalized for >48 hrs in the intensive care unit during a 9-month per...

We describe the case of an 18-yr-old male under anti-TNF treatment for Crohn's disease for more than 8 months. He developed fever and biological inflammatory syndrome without absolutely no accompanying sign or symptom or paraclinical abnormality despite extensive work-up performed in the context of his immunocompromised state. Symptoms disappeared...

BACKGROUND: Activation and coagulation biomarkers were measured within the Strategies for Management of Antiretroviral Therapy (SMART) trial. Their associations with opportunistic disease (OD) in human immunodeficiency virus (HIV)-positive patients were examined. METHODS: Inflammatory (high-sensitivity C-reactive protein [hsCRP], interleukin-6 [I...

Association of acquired autoimmune angioneurotic edema with other diseases is increasing. However, the precise mechanism by which antibodies to C1-esterase inhibitor (C1-INH) are produced, is not elucidated. We describe a patient with IgA antibodies against C1-INH without other autoimmune markers. Our patient had gastritis and Helicobacter pylori i...

BACKGROUND: Interruption of a non-nucleoside reverse transcriptase inhibitor (NNRTI)-regimen is often necessary, but must be performed with caution because NNRTIs have a low genetic barrier to resistance. Limited data exist to guide clinical practice on the best interruption strategy to use. METHODS: Patients in the drug-conservation arm of the S...

Background: When oral therapy is considered for BJI, combining rifampin with a fluoroquinolone (FQ) could be an attractive option. Among FQ, MOX has the best in vitro activity against Gram-positive cocci. However, no data is currently available regarding its safety and effectiveness in this setting. Method: All cases of BJI treated with MOX for mor...

Rising incidence rate of syphilis is observed in economically advanced countries, particularly among homosexual men and subpopulation with low socioeconomic status. The various clinical presentations are divided into early and late stages, including neurosyphilis. The latter can occur during any stage of the disease, leading to the question "when t...

BACKGROUND: Episodic use of antiretroviral therapy guided by CD4+ cell counts is inferior to continuous antiretroviral therapy. OBJECTIVE: To determine whether reinitiating continuous antiretroviral therapy in patients who received episodic treatment reduces excess risk for opportunistic disease or death. DESIGN: Randomized, controlled trial. SE...

Chronic hepatitis C virus (HCV) infection is associated with multifarious extra-hepatic manifestations; the most described and discussed being mixed cryoglobulinemia which is strongly related to B-cell lymphoproliferative disorders (LPDs). We present a case of chronic HCV infection and mixed cryoglobulinemia, with minimal liver involvement. The cas...

A unique case of mycotic aneurysm of the abdominal aorta caused by Streptococcus agalactiae in an afebrile patient presenting with abdominal pain is described. Although this bacterium is associated with a variety of infections in human beings, aortitis is uncommon. Chronic alcoholism and diabetes mellitus are the 2 major predisposing conditions for...

Besides opportunistic infections, direct or indirect HIV-mediated lesions of cerebral vascular or neural cells can also occur during the natural course of HIV infection. The main non-infectious complications of HIV are cerebral lymphomas, cerebrovascular disorders, HIV dementia and myelitis.

During the natural course of human immunodeficiency virus infection, central nervous system insults are very common. They can consist of infectious complications, consequently to the collapse of the patient's immune system. Alternatively, direct or indirect HIV-mediated lesions of cerebral vascular or neural cells can also occur. It is crucial to d...

The SMART study randomized 5,472 human immunodeficiency virus (HIV)-infected patients with CD4+ cell counts >350 cells/microL to intermittent antiretroviral therapy (ART; the drug conservation [DC] group) versus continuous ART (the viral suppression [VS] group). In the DC group, participants started ART when the CD4+ cell count was <250 cells/micro...

The SMART study compared 2 strategies for using antiretroviral therapy-drug conservation (DC) and viral suppression (VS)-in 5,472 human immunodeficiency virus (HIV)-infected patients with CD4+ cell counts >350 cells/microL. Rates and predictors of opportunistic disease or death (OD/death) and the relative risk (RR) in DC versus VS groups according...

Search term Clear input RSS feed iconRSS Save search Advanced Help Result Filters Abstract Send to: See 1 citation found by title matching your search: J Infect Dis. 2008 Apr 15;197(8):1133-44. doi: 10.1086/586713. Major clinical outcomes in antiretroviral therapy (ART)-naive participants and in those not receiving ART at baseline in the SMART...

BACKGROUND AND METHODS: The SMART study compared 2 strategies for using antiretroviral therapy-drug conservation (DC) and viral suppression (VS)-in 5,472 human immunodeficiency virus (HIV)-infected patients with CD4+ cell counts >350 cells/microL. Rates and predictors of opportunistic disease or death (OD/death) and the relative risk (RR) in DC ve...

Two double-blind randomised controlled studies (phase I and I/II) were performed to assess for the first time the safety and immunogenicity of a recombinant subunit gp350 Epstein-Barr virus (EBV) vaccine in 148 healthy adult volunteers. All candidate vaccine formulations had a good safety profile and were well tolerated, with the incidence of solic...

This review focuses on new antibiotics, particularly for gram-positive infections, new antiretroviral drugs, new treatment of fungal infections and indications of miltefosine in the treatment of leishmaniasis.

HIV infection remains a major problem of public health in Belgium as well as globally. The number of new diagnosies of HIV infection in Belgium remains between two and three daily. Given the dramatic effect of antiretroviral therapy on the mortality due to HIV infection, the number of patients is constantly increasing. The different problems relate...

The CD94/NKG2A heterodimer is a natural killer receptor (NKR), which inhibits cell-mediated cytotoxicity upon interaction with MHC class I gene products. It is expressed by NK cells and by a small fraction of activated CD8+ T lymphocytes. Abnormal upregulation of the CD94/NKG2A inhibitory NKR on cytotoxic T cells (CTLs) could be responsible for a f...

Despite declines in morbidity and mortality with the use of combination antiretroviral therapy, its effectiveness is limited by adverse events, problems with adherence, and resistance of the human immunodeficiency virus (HIV). We randomly assigned persons infected with HIV who had a CD4+ cell count of more than 350 per cubic millimeter to the conti...

We propose a review of history, aetiology, physiopathology, clinical features, treatment and prevention of nephropathia epidemica (NE) which represents the only form of Hantavirus infection in Belgium.

Alveolar echinococcosis is a serious parasitic disease, leading to large hepatic lesions. It must be distinguished from cystic echinococcosis, or hydatic cyst, caused by Echinococcus granulosus. Early diagnosis may allow surgical removal of the lesions by segmental hepatectomy, the only curative treatment. Parasitostatic medical treatment with albe...

Most of the echinococcosis cases treated in Belgium are contracted in African and Mediterranean countries. In this paper the authors describe the case of a Mediterranean patient suffering from a hepatic hydatid cyst treated by oral albendazole and laparoscopic liver resection.

There are nearly 31,000 HIV infected patients in Gabon. In Libreville, the capital, the prevalence is estimated at 7.7%. About 2627 tuberculosis patients, all types included, have been notified in 2001 to the World Health Organization of which 43% of smear positive new cases. The co-infection HIV-TB worsens the overall prognosis of our patients. Th...

The decision to initiate antiretroviral therapy will depend of the clinical status and of the CD4 counts of the patient. First line treatments will include two nucleoside inhibitors of reverse transcriptase (NRTIs). They will be associated to a non nucleoside inhibitor of reverse transcriptase or to a protease inhibitor (PI). With the exception of...

The authors had an aim to define the ideal patient profile by determining the factors responsible for an initial variation of CD4 lymphocytes and viral load, and the effect of these factors on the therapeutic response after 12 months of treatment in HIV infected patients. A retrospective study was made on data concerning the clinical stage, the HIV...

Ebola hemorrhagic fever appears after an incubation of 3 days to 3 weeks. The first symptoms are fever accompanied by general and hemorrhagic signs leading to death in 50 to 90% of cases. During epidemics definition of cases permits prompt diagnosis. Due to the high risk of person-to-person and nosocomial transmission associated with Ebola hemorrha...

Objective. – The authors had an aim to define the ideal patient profile by determining the factors responsible for an initial variation of CD4 lymphocytes and viral load, and the effect of these factors on the therapeutic response after 12 months of treatment in HIV infected patients.Patients and method. – A retrospective study was made on data con...

Borrelia burgdorferi infection is a frequent disease in our country. The neurological complications of this infection are found essentially in the early dissemination stage and in the late stage of the disease. Neuroborreliosis symptoms are most often characterized by radiculalgia resisting to treatment, sometimes associated to a cranial neuropathy...

Great scourge of poor countries, malaria is the most important tropical parasitic disease. It is responsible for a large number of deaths in concerned countries and represents a real danger for travellers going to endemic regions. So, prophylactic measures are essential. On the one hand protective measures against mosquito bites, by wearing coverin...

We present data from 112 patients followed in the Infectious Diseases Unit of the Liege University Hospital (CHU Sart-Tilman). The primary goal of this study was to evaluate the efficiency of highly active antiretroviral therapy (HAART) on surrogate immunological and virological parameters. The study also aimed at determining the prevalence of oppo...

The Adult Onset Still's Disease (AOSD) is an entity of unknown origin characterised by fever, polyarthralgias or polyarthritis, a pharyngitis, a cutaneous eruption and elevation of leucocytes. We present observations of 17 patients diagnosed during the last thirteen years. Files of hospitalized patients with suspected AOSD have been examined in a r...

The long term use of antiretroviral therapy is associated with metabolic and morphological abnormalities named lipodystrophy. The understanding of its epidemiology is in progress. NRTIs and Pls are involved in the origin of these abnormalities. So, NRTIs inhibit mitochondrial gamma polymerase and induce body fat distribution disorders. PIs interfer...

Protease inhibitors constitute the last class of antiretroviral drugs appeared on the market. They raised an enormous enthusiasm, reinforced by recent studies results. These molecules prevent the formation of infectious viral particles, while inhibiting a viral enzyme that plays a key role in the cycle of replication of the HIV. Their efficiency, e...

We report a fatal methanol intoxication and discuss its physiopathology, diagnosis and treatment.

Hydroxyurea is an anticancerous product, used recently in the treatment of HIV-1 infection thanks to its inhibitory action in viral replication, potentialization of the nucleosides activity (particularly ddI or didanosine) and its cytostatic properties on CD4 and CD8 lymphocytes. Many studies showed its efficiency, as further drug, in initial regim...

Non nucleoside reverse transcriptase inhibitors (NNRTI) are a new arm in the treatment of the HIV infection. They inhibit the replication by direct non competitive binding to the enzyme, and do not require phosphorylation. The fast emergence of resistance in monotherapy obliges to use them in a triple association. The 103 mutation confers a cross-r...

Nevirapine is the first non nucleoside reverse transcriptase inhibitor registered in Belgium and indicated in the treatment of HIV-1 infection. In association with 2 nucleoside analogues, its efficiency is similar to a tritherapy with protease inhibitor, particularly in naive patients with low viral load. It has a good tolerance profile and is easy...