Méningo-encéphalite à Virus Varicelle-Zona survenue chez une immunocom: Varicella Zoster Virus meningoencephalitis in an immunocompetent woman: an unusual case report

The Varicella Zoster Virus (VZV) causes a wide range of disorders including chickenpox, shingles and central nervous system (CNS) infection It has the ability to remain latent in neurons of cranial  nerves, dorsal root ganglia, and autonomic ganglia after primary infection and can reactivate later in life Upon reactivation, VZV can cause a variety of CNS infections, including meningitis and encephalitis Significant morbidity and mortality may be associated with these conditions despite antiviral therapy We have reported a case of varicella re-infection in an immunocompetent adult with ophthalmic zoster and fatal outcome under antiviral treatment. Le virus varicelle-zona (VZV) provoque un large éventail de troubles y compris la varicelle, le zona et l’infection du système nerveux central (SNC) Il a la capacité de rester latent dans les neurones des nerfs crâniens, les ganglions de la racine dorsale et les ganglions autonomes après infectionprimaire et peut se réactiver plus tard dans la vie Lors de la réactivation, le VZV peut provoquer diverses infections du SNC, dont la méningite et l'encéphalite Une morbidité et une mortalité importantes peuvent être associées à ces conditions malgré un traitement antiviral Nous rapportons un cas de réinfection varicelleuse chez une adulte immunocompétente avec Zona ophtalmique d’évolution défavorable sous traitement antiviral

Current clinical presentations of AIDS dementia in a tropical environment: study of 26 observations in the neurology department of the University Hospital of Conakry

Abstract Introduction In sub-Saharan Africa (SSA), the clinical and progressive diagnostic certainty of AIDS dementia is difficult to establish due to under-medicalization and delays in consultation and especially the diversity of etiologies of demented states. Material and methods We carried out a retrospective study of 196 patients hospitalized for dementia syndrome between 2016 and 2021 in the neurology department of the University Hospital of Conakry. The criteria labeled in this study are those retained by the DSM-IV and the classification of the American Academy of Neurology (AAN) developed in accordance with the WHO. Results HIV etiology was identified in patients aged 44–67 years (17 women and 19 men). The clinical picture was dominated by severe cognitive disorders, slowed ideation, memory disorders and reduced motor skills associated with personality changes. Neurological examination revealed dysphoric disorders in most patients, sphincter abnormalities in 13 cases and labio-lingual tremor in 11 cases. Diagnosis was based on positive serological tests for HIV1 antibodies (25 cases) and HIV2 antibodies (1 case) using the Elisa and Western blot techniques, and the presence of discretely hypercellular CSF. Magnetic resonance imaging contributed to the diagnosis, showing diffuse white matter abnormalities with hyper signals on T2-weighted or FLAIR sequences. Conclusion This study shows a non-stereotype clinical picture of AIDS dementia requiring a differential diagnosis with other infectious dementias. These results are important for the therapeutic and prognostic discussion