Dengue and coronavirus disease 2019 (COVID-19) may share clinical and laboratory features. Reunion Island is a French overseas department located in the Indian Ocean with a population of more than 850,000 inhabitants. Due to its tropical climate, Reunion Island is at risk of arbovirus outbreaks. An increase in the number of dengue cases has been reported on the island since the beginning of 2018, with 3 different serotypes circulating mostly in austral summer. According to the last epidemiological report of March 30, 2020 from Santé Publique France, 3,144 new cases of dengue have been diagnosed since the beginning of 2020 in Reunion Island [1]. On March 2020, the first COVID-19 cases were imported to the island from metropolitan France by airplane. We report the case of an 18-year-old male living in Reunion Island, with no relevant past medical history except occasional migraines. Our patient travelled back from Strasbourg (initial French epicenter of COVID-19) to Reunion Island on March 18, 2020. After his arrival, he returned to his parents' home, respected national confinement guidelines, and only went shopping once. The onset of symptoms occurred on April 3, with fever (39˚C), asthenia, anorexia, and headache. On April 4, he tested positive in the emergency department for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection by reverse transcription (RT)-PCR (E gene, RdRP gene, and N gene positive), the causative virus of COVID-19. He was discharged from the emergency room after diagnosis. On April 5, an itchy erythema rash appeared. He came back to the hospital on April 7 for persistent fever (38.7˚C), arthromyalgia, dyspnea with polypnea (respiratory rate of 24 breaths per minute), and itchy maculopapular rash. The dengue rapid test was positive (NS1 antigen+) in the emergency department. Therefore, he was hospitalized the same day in the COVID-19 unit of St Denis University Hospital Center. The physical examination revealed a body temperature of 38˚C, blood pressure of 112/63 mmHg, pulse of 63 beats per minute, and oxygen saturation of 99% in ambient air. He had dry cough (since February) and no chest pain. Pulmonary auscultation was normal. He had no hematuria. He described retro-orbital eye pain and mild photophobia, with anorexia, nausea, and vomiting. He had infracentimetric cervical lymphadenopathies. Skin examination showed a roseoliform maculopapular exanthema of the trunk, limbs, and face, which rapidly evolved into a scarlatiniform-like rash. There were no real intervals of healthy skin but rounded islands of sparing ("white islands in a sea of red") (Figs 1 and 2). There was no mucosal involvement nor hand and feet affection involvement. The itching had stopped, and there was no scratching

is a rare species of slow-growing nontuberculous mycobacteria (NTM). From 2002 to 2017, we conducted a retrospective study that included all patients with NTM-positive respiratory samples detected in two university hospitals of the French overseas department of Reunion Island. We recorded the prevalence of in this cohort, as well as the clinical, radiological, and microbiological features of patients with at least 1 sample positive for In our cohort, 97 patients (15.1%) were positive for Twenty-one patients (21.6%) met the American Thoracic Society (ATS) criteria for infection. infection was associated with bronchiectasis, micronodular lesions, and weight loss. Antibiotic susceptibility testing was performed for 60 patients, and the isolates were found to have low susceptibility to antibiotics, except for amikacin, fluoroquinolones, and clarithromycin. Treatment failed for 4 of the 8 patients treated for infection. Here, we describe a specific cluster corresponding to a large cohort of patients with, a rare nontuberculous mycobacterium associated with low pathogenicity and poor susceptibility to antibiotics.

Quantitative reverse transcription PCR (RT-PCR) has become an important tool for studying functional gene expression. However the most often used cycle threshold (CT)-based method, primarily related to the required amplification efficiency determination via serial dilution, can call into question the level of quantitative reliability and accuracy that can be achieved, in addition to the impracticalities inherent to CT-based methodologies. In this study, an alternative method, named the sigmoidal curve-fitting (SCF) method, was compared with the classic CT method for two target genes (XRCC4 and HIF-1alpha) and a reference gene (HPRT). The PCR conditions were optimized for each gene on a LightCycler apparatus. Fluorescence data were fitted to a four-parametric sigmoidal function, and the initial messenger RNA (mRNA) copy number was determined by a theoretical fluorescence (F0) value calculated from each fitting curve. The relative expression of the target gene versus that of the reference gene was calculated using an equation based upon these F0 values. The results show that the F0 value had a good linearity with the initial number of target genes between 10(7) and 10(1) copies. The reproducibility tests showed that the variations of initial target quantity were well reflected by F0 values. Relative expression of target gene calculated by the SCF method and by the CT method showed similar results. In our hands, the SCF method gave reliable results and a more precise error description of quantitative RT-PCR.

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Background The surgical lung biopsy (SLB) is the recommended sampling technique when the pathological analysis of the lung is required in the work-up of an interstitial lung disease (ILD) but trans-bronchial lung cryobiopsy (TBLC) is increasingly recognized as an alternative approach. As TBLCs have lower mortality and morbidity risks than SLB, this study aimed to investigate the safety of TBLCs in patients at higher risk of complications and for whom SLB was not considered as an alternative. Method This prospective study was conducted in two hospitals in which TBLCs were performed in patients with body mass index (BMI) > 35, and/or older than 75 years, and/or with severely impaired lung function (FVC < 50% or DLCO < 30%), and/or systolic pulmonary artery pressure > 45 mmHg, and/or a clinically significant cardiac disease. Patients with any of these risk factors constituted the high-risk group. Clinical outcomes were compared with those obtained in patients without these risk factors (low-risk group). Results Ninety-six patients were included between April 2015 and April 2020, respectively 38 and 58 in the high-risk or the low-risk group. No statistically significant difference was observed between both groups in terms of severity and rate of bleeding, pneumothorax, or duration of hospital stay (p value ranging from 0.419 to 0.914). Conclusion This preliminary study on a limited number of patients suggests that TBLC appears safe in those in whom lung biopsy is at high-risk of complications according to their age, BMI, lung impairment, and cardiac comorbidities.

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