Disseminated Herpes Zoster in the Immunocompetent, A Case at Zinder National Hospital

Introduction: Herpes zoster, shingles, is a secondary pathology due to a reactivation of the varicella-zoster virus (VZV) and common in the general population. It is responsible for a painful skin rash localized in the area of the body innervated by a nerve root. The rash can be widespread affecting several dermatomes especially in the immunocompromised subject. Observation: We report an observation of disseminated shingles in an immunocompetent adult hospitalized in the Internal Medicine Department of Zinder National Hospital. AT 55 years old, was admitted for management of a very painful skin rash. Pruriginous vesicles extended diffusely out of the metameric topography to all the enveloping membranes of the body including vulvo-vaginal and oral enanthem. Biologically, blood count (CBC), blood glucose, and renal function were normal. Human immunodeficiency virus (HIV) status was negative. The clinical course was uneventful characterized by apyrexia at 48 hours and drying of the lesions. Medical care was based on symptomatic treatment. Conclusion: Shingles is a common viral disease, but potentially serious in some situations. The disseminated form is exceptional in the immunocompetent subject. Its detection and early treatment ensure a reduction in the severity of the complications. &nbsp

Prevalence of Mutations in the \u3ci\u3ePfdhfr\u3c/i\u3e, \u3ci\u3ePfdhps\u3c/i\u3e, and \u3ci\u3ePfmdr1\u3c/i\u3e Genes of Malarial Parasites Isolated from Symptomatic Patients in Dogondoutchi, Niger

The effectiveness of artemisinin-based combination therapies (ACTs) depends not only on that of artemisinin but also on that of partner molecules. This study aims to evaluate the prevalence of mutations in the Pfdhfr, Pfdhps, and Pfmdr1 genes from isolates collected during a clinical study. Plasmodium genomic DNA samples extracted from symptomatic malaria patients from Dogondoutchi, Niger, were sequenced by the Sanger method to determine mutations in the Pfdhfr (codons 51, 59, 108, and 164), Pfdhps (codons 436, 437, 540, 581, and 613), and Pfmdr1 (codons 86, 184, 1034, and 1246) genes. One hundred fifty-five (155) pre-treatment samples were sequenced for the Pfdhfr, Pfdhps, and Pfmdr1 genes. A high prevalence of mutations in the Pfdhfr gene was observed at the level of the N51I (84.97%), C59R (92.62%), and S108N (97.39%) codons. The key K540E mutation in the Pfdhps gene was not observed. Only one isolate was found to harbor a mutation at codon I431V. The most common mutation on the Pfmdr1 gene was Y184F in 71.43% of the mutations found, followed by N86Y in 10.20%. The triple-mutant haplotype N51I/C59R/S108N (IRN) was detected in 97% of the samples. Single-mutant (ICS and NCN) and double-mutant (IRS, NRN, and ICN) haplotypes were prevalent at 97% and 95%, respectively. Double-mutant haplotypes of the Pfdhps (581 and 613) and Pfmdr (86 and 184) were found in 3% and 25.45% of the isolates studied, respectively. The study focused on the molecular analysis of the sequencing of the Pfdhfr, Pfdhps, and Pfmdr1 genes. Although a high prevalence of mutations in the Pfdhfr gene have been observed, there is a lack of sulfadoxine pyrimethamine resistance. There is a high prevalence of mutation in the Pfmdr184 codon associated with resistance to amodiaquine. These data will be used by Niger’s National Malaria Control Program to better monitor the resistance of Plasmodium to partner molecules in artemisinin-based combination therapies