Publications of Philippe LEONARD
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See detailArtesunate et paludisme severe en pediatrie.
LEFEVRE, Annabelle ULiege; LEONARD, Philippe ULiege

in Revue medicale de Liege (2019), 74(10), 503-507

Malaria is a life-threatening infection which affects especially non-immune subjects including children under the age of 5. Imported malaria is a rare disease in Europe but, with the increasing number of ... [more ▼]

Malaria is a life-threatening infection which affects especially non-immune subjects including children under the age of 5. Imported malaria is a rare disease in Europe but, with the increasing number of travelers and people who are visiting friends or relatives, it is important not to neglect it. Severe malaria leads to many pediatric deaths in countries with limited resources. The treatment of choice is a parenteral antimalarial. For a long time, only quinine was used in that case. Based on strong studies conducted in Asia and Africa, WHO (World Health Organization) has recommended the use of artesunate as a first-line treatment for severe malaria in adults and children since 2010.The use of artesunate has shown a reduction in mortality rate in severe malaria. In Europe, there still are several barriers to the implementation of these recommendations, especially in terms of availability and cost. In pediatrics departments and adults, artesunate is the first-line treatment in severe malaria, although close monitoring is essential, especially at the hematological side, monitoring the development of delayed post-artesunate haemolytic anemia (PADH), a known side effect. [less ▲]

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See detailBorréliose de Lyme
HUYNEN, Pascale ULiege; LEONARD, Philippe ULiege

Scientific conference (2019, March 11)

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See detailHepatic alveolar echinococcosis.
DETRY, Olivier ULiege; MEURISSE, Nicolas ULiege; Delwaide, Jean ULiege et al

in Acta Chirurgica Belgica (2018), 118(3), 200-201

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See detailAlveolar echinococcosis in southern Belgium: retrospective experience of a tertiary center.
Cambier, Audrey ULiege; LEONARD, Philippe ULiege; Losson, Bertrand ULiege et al

in European Journal of Clinical Microbiology and Infectious Diseases (2018), 37(6), 1195-1196

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See detailPrise en charge multidisciplinaire de l'echinococcose alveolaire : le groupe Echino-Liege.
Cambier, Audrey; GIOT, Jean-Baptiste ULiege; LEONARD, Philippe ULiege et al

in Revue Médicale de Liège (2018), 73(3), 135-142

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 ... [more ▼]

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 to 62 %) in foxes. Cats and dogs can act as definitive hosts. Human are accidentally infected by ingestion of food contaminated by the feces. After a long incubation period, invasive hepatic lesions may appear, as well as extra-hepatic lesions. The disease may be fatal. The diagnosis is based on imaging techniques, serology and nucleic acid detection in tissues. Early diagnosis may allow surgical removal of the lesion associated with at least 2 years of albendazole postoperative treatment. In case of contraindication to surgery, a long term treatment with albendazole is necessary. Liver transplantation is sometimes necessary. This article presents the epidemiologic, clinical, diagnostic and therapeutics features of this zoonotic disease. [less ▲]

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See detailPrise en charge multidisciplinaire d'une volumineuse hydatidose hepatique.
HALLEUX, Danaé ULiege; Juriens, I.; Delwaide, Jean ULiege et al

in Revue Médicale de Liège (2018), 73(2), 65-71

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 ... [more ▼]

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 a patient suffering from a 28 cm cystic echinococcosis treated by combination of albendazole and liver resection. Several treatment options are described in the literature although there is currently no clear consensus on the management of this condition. [less ▲]

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See detailL’Echinococcose alvéolaire, une zoonose émergente en Wallonie. Une approche « one health » par le groupe ECHINO-LIEGE
Cambier, Audrey ULiege; DETRY, Olivier ULiege; Lempereur, Laetitia ULiege et al

in Veterinaria: Bulletin d'Information de l'Union Syndicale Vétérinaire Belge (2018)

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See detailRecurrence of visceral and muco-cutaneous leishmaniasis in a patient under immunosuppressive therapy
DARCIS, Gilles ULiege; Van der Auwera, Gert; GIOT, Jean-Baptiste ULiege et al

in BMC Infectious Diseases (2017), 17

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 ... [more ▼]

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 alignant diseases. The disease can present in three ways: cutaneous, mucocutaneous, or visceral leishmaniasis, which rarely occur together or consecutively. Case presentation: The patient was a 52 years old immunosuppressed Belgian woman with a long history of severe rheumatoid arthritis. She underwent bone marrow biopsy to explore thrombocytopenia. Diagnosis of visceral leishmaniasis was made by identification of Leishman Donovan (LD) bodies in macrophages. Treatment with liposomal amphotericin B was successful. She later developed cutaneous leishmaniasis treated with amphotericin B lipid complex. She next presented with relapsing cutaneous lesions followed by rapidly progressing lymphadenopathies. Biopsy confirmed the diagnosis of leishmaniasis. Treatments by miltefosine, amphotericin B, N-methyl-glucamine antimoniate were subsequently initiated. She later presented a recurrent bone marrow involvement treated with intramuscular paromomycin and miltefosine. She died two years later from leukemia. At the time of death, she presented with a mucosal destruction of the nose. A Leishmania-specific PCR (Polymerase Chain Reaction) identified L. infantum as etiological agent. Conclusions: Clinicians should be aware of the potential concomitant or sequential involvement of multiple anatomic localizations of Leishmania in immunosuppressed patients. [less ▲]

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See detailEndocardite à aggregatibacter aphrophilus sur prothèses valvulaires
Deleixhe, Benjamin ULiege; FRIPPIAT, Frédéric ULiege; Léonard, Philippe ULiege et al

in Revue Médicale de Liège (2017), 72(12), 522-528

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 ... [more ▼]

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 specificities of endocarditis due to the HACEK group (Haemophilus spp., Aggregatibacter, Cardiobacterium hominis, Eikenella corrodens and Kingella spp.) and the specific microbiological data and therapeutic options pertinent to this germ are discussed. [less ▲]

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See detailQ Fever Serological Survey and Associated Risk Factors in Veterinarians, Southern Belgium, 2013
Dal Pozzo, Fabiana ULiege; Martinelle, Ludovic ULiege; Léonard, Philippe ULiege et al

in Transboundary and Emerging Diseases (2017), 64(3), 959-966

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 ... [more ▼]

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 increased to 58.3% among veterinarians having contact with livestock. Three main serological profiles were detected (relatively recent, past and potentially chronic infections). The contact with manure during the prior month was the risk factor associated with seropositivity after multivariate logistic regression analysis. Classification and regression tree analysis identified the age as the most predictive variable to exclude potentially chronic infection in apparently healthy seropositive veterinarians. In conclusion, livestock veterinarians practicing in Southern Belgium are highly exposed to Q fever, a neglected zoonosis for which serological and medical examinations should be envisaged in at risk groups. © 2016 Blackwell Verlag GmbH [less ▲]

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See detailEstimating the economic impact of a possible equine and human epidemic of West Nile virus infection in Belgium
Humblet, Marie-France ULiege; Vandeputte, Sébastien; Fecher-Bourgeois, Fabienne ULiege et al

in Euro Surveillance: Bulletin Européen sur les Maladies Transmissibles (2016), 21(31),

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 ... [more ▼]

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 vector of the virus, allowed us to determine equine and human populations at risk. Characteristics of the different clinical forms of the disease based on past epidemics in Europe allowed morbidity among horses and humans to be estimated. The main costs for the equine sector were vaccination and replacement value of dead or euthanised horses. The choice of the vaccination strategy would have important consequences in terms of cost. Vaccination of the country’s whole population of horses, based on a worst-case scenario, would cost more than EUR 30 million; for areas at risk, the cost would be around EUR 16–17 million. Regarding the impact on human health, short-term costs and socio-economic losses were estimated for patients who developed the neuroinvasive form of the disease, as no vaccine is available yet for humans. Hospital charges of around EUR 3,600 for a case of West Nile neuroinvasive disease and EUR 4,500 for a case of acute flaccid paralysis would be the major financial consequence of an epidemic of West Nile virus infection in humans in Belgium. [less ▲]

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See detailLouse-borne relapsing fever in a refugee from Somalia arriving in Belgium
DARCIS, Gilles ULiege; Hayette, Marie-Pierre ULiege; BONTEMS, Sébastien ULiege et al

in Journal of Travel Medicine (2016), 23(3),

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 ... [more ▼]

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 through endemic regions. [less ▲]

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See detailExuberant inflammatory reaction as a side effect of platelet-rich plasma injection in treating one case of tendinopathy
Kaux, Jean-François ULiege; Croisier, Jean-Louis ULiege; LEONARD, Philippe ULiege et al

in Clinical Journal of Sport Medicine (2014), 24(2), 150-152

Platelet-rich plasma (PRP) contains a large quantity of growth factors, which may enhance tendon healing processes. Local infiltration of PRP represents a relatively new treatment for tendinopathies. To ... [more ▼]

Platelet-rich plasma (PRP) contains a large quantity of growth factors, which may enhance tendon 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. We reported a case of exuberant inflammatory reaction after one infiltration of PRP to treat jumper’s knee in a type 1 diabetic patient who was 35 years old. Injections of PRP must be proposed after careful consideration for patients with morbidity risks linked to insulin-dependent diabetes. [less ▲]

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See detailChronic Cutaneous Hyalophomycosis by Paecilomyces
BOUFFLETTE, Nicolas ULiege; Arrese Estrada, Jorge ULiege; LEONARD, Philippe ULiege et al

in Open Dermatology Journal (2014), 8

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 ... [more ▼]

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 often delayed. A 60-year-old woman with idiopathic chronic necrotizing vasculitis treated since 10 years with a series of immunosuppressive therapies presented since three years various clinical presentations of chronic hyalohyphomycosis caused by P. lilacinus. Diagnosis was only obtained three years after the first clinical signs, following the histologic analysis of the surgical excision of a cutaneous abscess. Treatment with oral voriconazole was successful. This case report illustrates the highly heterogeneous clinical aspects of hyalohyphomycosis by P. lilacinus leading to a delay in diagnosis and treatment, particularly in the immunosuppressed patient. [less ▲]

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See detailA case of hemolytic anemia after severe malaria successfully treated with artesunate
ROUYA, Laura ULiege; LEONARD, Philippe ULiege; Hayette, Marie-Pierre ULiege

Poster (2013, October 24)

Intravenous artesunate is the treatment of choice for severe and complicated malaria according to the WHO 2010 guidelines. Seventeencases of delayed hemolysis after parenteral treatment with artesunate ... [more ▼]

Intravenous artesunate is the treatment of choice for severe and complicated malaria according to the WHO 2010 guidelines. Seventeencases of delayed hemolysis after parenteral treatment with artesunate have been recently reported in European travellers with imported Plasmodium falciparummalaria1. We report the case of a 40-years-old Belgian man who contracted severe falciparum malaria after a four-weeks stay in Central and Eastern Africa without taking any antimalarial chemoprophylaxis. He presented on admission with fever, headache, jaundice andabdominal syndrome.Thereafter hisbiological and clinical conditionrapidly worsened withconsciousness disorders, severe thrombocytopenia,acute hepatitis and pancreatitis, and renal failure. Parasitemia reached a peak of 37 % on the second day of admission. Since this patient fulfilled WHO 2010 criteria for severe malaria,intravenous artesunatetreatment dosed at 2,4 mg/kg was started. Parasite clearancewas obtained after 48 hours and the patient’s clinical status improved significantly.Five doses of intravenous artesunate were administered, followed by oral artemeter/lumefantrine treatment during 60 hours. Tendays after the first dose of artesunate the patient developed a severe hemolyticanemia(hemoglobin4,9 g/dL) associated with impaired renal function. Thick blood film was negative. Blood transfusion and high doses of corticosteroids were successfully administrated and hemodialysis was not necessary. Until now, no clear explanation has been given to this complication. This case highlights the usefulness of extended follow-up including haematological parametersforpatients treated with artesunate, at least one monthafter the malaria episode. 1Published reports of delayed hemolyticanemia after treatment with artesunate for severe malaria--worldwide, 2010-2012. Centers for Disease Control and Prevention (CDC). [less ▲]

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See detailRéaction inflammatoire exubérante comme effet secondaire d’une infiltration de PRP
Kaux, Jean-François ULiege; Croisier, Jean-Louis ULiege; LEONARD, Philippe ULiege et al

in Annals of Physical and Rehabilitation Medicine (2013, October), 56(Sup 1), 068

Introduction : Infiltrations of plasma rich platelets (PRP) represent a new treatment of tendinopathies. Currently, no side effects were reported in this indication. Case report: We report the case of a ... [more ▼]

Introduction : Infiltrations of plasma rich platelets (PRP) represent a new treatment of tendinopathies. Currently, no side effects were reported in this indication. Case report: We report the case of a 35-year-old type 1 diabetic patient with right upper patellar tendinopathy that had persisted for more than 6 months. The patient benefited from an intratendinous infiltration of 6 mL of PRP (8.105 platelets/mm3, almost no red or white blood cells) after a carefully disinfection but without local anesthesia. Typically, a standardized program of sub-maximal eccentric rehabilitation should be started 1 week after infiltration. However, the patient experienced local swelling with erythema, increased heating and pain, which appeared just underneath the patella, without biological inflammatory syndrome. In absence of septic general symptoms, no blood or wound culture were made. At 2 weeks post-infiltration, a greatly increased Doppler signal in a thicker tendon was observed by ultrasounds compared to that before infiltration, but there was no sign of infection demonstrated by either MRI or CT. However, the local inflammation did not decrease after a 3-week treatment of local cryotherapy, local and oral NSAID, and adjunct use of colchicine 1 mg. Thus, an insidious infection was suspected, even though there was no evidence of biological inflammatory syndrome or sign of infectious lesion on imagery examination. Antibiotic therapy (rifampicine 600 mg + minocycline 100 mg), was initiated for three months. Due to a lack of improvement via imaging and clinical examination, a 3-phase bone scintigraphy was performed. The results suggested the presence of a complex regional pain syndrome type 1. The patient benefited from classical physical therapy and concomitant pain killers. The evolution was favorable after 6 months of treatment. Discussion : Even though PRP infiltration represents a new and promising treatment for tendinopathy, more studies are needed both to verify its clinical efficacy. Moreover, implementing this innovative treatment requires caution because of potential adverse events. Thus, the balance between benefits and risks must be carefully evaluated before using this treatment, especially in patients with type 1 diabetes. [less ▲]

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See detailRéaction inflammatoire exubérante suite à une infiltration de PRP
Kaux, Jean-François ULiege; Croisier, Jean-Louis ULiege; LEONARD, Philippe ULiege et al

in European Journal of Sports Medicine (2013, September), 1(Supplement 1), 278-279

Background: PRP, obtained from centrifuged autologous blood, contains a large quantity of growth factors, which may enhance the tissue healing processes. Local infiltration of PRP represents a relatively ... [more ▼]

Background: PRP, obtained from centrifuged autologous blood, contains a large quantity of growth factors, which may enhance the 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. Case report: A 35-year-old patient had a right upper patellar tendinopathy which was resistant to all conservative treatments for more than 6 months. The patient was a type 1 diabetic (well controlled). He had an intratendinous infiltration of 6 mL of PRP (8.105 platelets/mm3, almost no red or white blood cells) after disinfection but without local anaesthetic. Immediately following the infiltration, local cryotherapy was performed for 15 minutes. NSAIDs were avoided, but class-1 or -2 pain-killers were authorised if necessary. A standardised sub-maximal eccentric rehabilitation should have been started 1 week after. However, the patient experienced local swelling with erythema, increased heating and pain which appeared just underneath the patella, but without biological inflammatory syndrome. A great Doppler signal in a thicker patellar tendon was observed by US, but there was no sign of local infectious disease demonstrated by either CT or MRI. However, the local inflammation did not decrease after a progressive 3-week treatment of local cryotherapy, local and oral NSAIDs and colchicine 1 mg. Thus, an insidious infection was suspected, even though there was neither evidence of biological inflammatory syndrome nor sign of infectious lesion on imagery examination. An antibiotic therapy (rifampicine 600 mg + minocycline 100 mg) was initiated for 3 months. Finally, a 3-phase bone scintigraphy suggested the presence of a complex regional pain syndrome type 1 treated by a classical physical therapy and concomitant class-2 pain killers. The evolution was favourable after 6 months of symptomatic treatment, and the pain decreased to a level similar to that before the infiltration of PRP. Discussion/Conclusions: This case report draws attention to potential side effects that are linked to this new therapy by infiltration of platelet rich plasma in case of tendinopathy, in particular when used in patients with type 1 diabetes. Thus, the balance between benefits and risks must be carefully evaluated before using this treatment in patients with type 1 diabetes. [less ▲]

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See detailExuberant inflammatory reaction after an infiltration of platelet-rich plasma (PRP)
Kaux, Jean-François ULiege; Croisier, Jean-Louis ULiege; LEONARD, Philippe ULiege et al

in British Journal of Sports Medicine (2013, June), 47(10 (e3)), 92

Background: PRP, obtained from centrifuged autologous blood, contains a large quantity of growth factors, which may enhance the tissue healing processes. Local infiltration of PRP represents a relatively ... [more ▼]

Background: PRP, obtained from centrifuged autologous blood, contains a large quantity of growth factors, which may enhance the 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. Case report: A 35-year-old patient had a right upper patellar tendinopathy which was resistant to all conservative treatments for more than 6 months. The patient was a type 1 diabetic (well controlled). He had an intratendinous infiltration of 6 mL of PRP (8.105 platelets/mm3, almost no red or white blood cells) after disinfection but without local anaesthetic. Immediately following the infiltration, local cryotherapy was performed for 15 minutes. NSAIDs were avoided, but class-1 or -2 pain-killers were authorised if necessary. A standardised sub-maximal eccentric rehabilitation should have been started 1 week after. However, the patient experienced local swelling with erythema, increased heating and pain which appeared just underneath the patella, but without biological inflammatory syndrome. A great Doppler signal in a thicker patellar tendon was observed by US, but there was no sign of local infectious disease demonstrated by either CT or MRI. However, the local inflammation did not decrease after a progressive 3-week treatment of local cryotherapy, local and oral NSAIDs and colchicine 1 mg. Thus, an insidious infection was suspected, even though there was neither evidence of biological inflammatory syndrome nor sign of infectious lesion on imagery examination. An antibiotic therapy (rifampicine 600 mg + minocycline 100 mg) was initiated for 3 months. Finally, a 3-phase bone scintigraphy suggested the presence of a complex regional pain syndrome type 1 treated by a classical physical therapy and concomitant class-2 pain killers. The evolution was favourable after 6 months of symptomatic treatment, and the pain decreased to a level similar to that before the infiltration of PRP. Discussion/Conclusions: This case report draws attention to potential side effects that are linked to this new therapy by infiltration of platelet rich plasma in case of tendinopathy, in particular when used in patients with type 1 diabetes. Thus, the balance between benefits and risks must be carefully evaluated before using this treatment in patients with type 1 diabetes. Reference: Platelet-rich plasma application in the management of chronic tendinopathies. Acta Orthop Belg 2013; 79: 10-15. [less ▲]

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