Naujagimių vėjaraupiai. Klinikinis atvejis ir literatūros apžvalga

Vėjaraupiai – tai ūminė virusinė liga, kurios sukėlėjas yra žmogaus herpes virusas, vadinamas Varicella zoster virusu (VZV) ir priklausantis Herpes viridae šeimai [1]. Didžiausią pavojų šis virusas sukelia nėščiosioms ir asmenims, kurių imunitetas nusilpęs. Nustatyta, kad nėštumo laikotarpiu vėjaraupiais suserga 2–3 iš 10 000 nėščiųjų [2]. Nėščiosioms po 16 nėštumo savaitės, ypač trečią nėštumo trečdalį, komplikuotų vėjaraupių rizika yra dar didesnė nei kitiems suaugusiems asmenims. VZV infekcija nėštumo laikotarpiu siejama su tokiomis komplikacijomis kaip pneumonija, įgimtu vėjaraupių sindromu ir naujagimių vėjaraupiais. Straipsnyje pristatomas klinikinis nėščiosios ir naujagimio vėjaraupių atvejis bei literatūros apžvalga.

Clinical and Therapeutic Aspects of Viral Ocular Pathology in Brazzaville

Introduction: Viruses can act in two ways, either by a direct pathogenic effect, or indirectly by inducing immunosuppression and favoring the action of other so-called opportunistic viruses. This survey had a double objective, describe the clinical aspects of viral ocular pathology and state its principles of treatment. Materials and Methods: Descriptive cross-sectional study carried out over 2 years at the Ophthalmology department of the University Hospital of Brazzaville. Patients 18 years of age or older with viral ocular pathology were included. The diagnosis was made on the sole basis of anamnestic and / or clinical arguments. None of the viruses involved had been directly detected, with the exception of HIV. Biologically proven patients with a coinfection (bacteria, parasite, fungus) were excluded. HIV serology had been systematic. Four parameters were analyzed: type of virus, structures affected, pathologies diagnosed, anti viral treatments used. Results: Two hundred twenty-five (225) patients were included. The mean age was 44 ± 2.1 years. Sex ratio was 0.8. Viruses: Adenovirus (51.1%), Herpes zoster (19.5%), HIV (18.7%), Herpes simplex (7.5%), CMV (3.2%). Main structures affected: eyelid (86.2%), chorioretin (6.4%). Main pathologies: Adenovirus conjunctivitis (61.1%), shingles (16%), primary herpes simplex infection (8%) Keratitis (6.4%), chorioretinitis (6.4%), uveitis (2.1%). Anti viral treatments used: Valaciclovir, Ganciclovir and anti retroviral. Conclusion: Viral ocular pathology is dominated by Adenovirus conjunctivitis and infections due to 3 types of herpes viridae (Herpes zoster, Herpes simplex and CMV). These herpes viridae are generally responsible for opportunistic diseases following immunosuppression linked to HIV.

Role of Cytomegalovirus Replication in Alopecia Areata Pathogenesis

Background: Cytomegalovirus (CMV) infection has been correlated with various autoimmune disorders. Using molecular biology techniques, DNA sequences of CMV have been reported in paraffin sections of alopecia areata (AA) lesions. Reactivation of the CMV infection has been postulated as one of the pathogenic mechanisms in AA. Other studies, using different techniques however have demonstrated no correlation between CMV and AA. Objectives: This study was to clarify the role of CMV infection and to demonstrate the absence of replication of other autoimmune diseases-related herpes virus (EBV) in the pathogenesis of AA. Methods: After extraction of mRNA from tissue samples of a patient with active patchy AA, reverse transcriptase-polymerase chain reaction was carried out using primers specific for some viral members of the β-herpes viridae family (CMV, EBV, HSV). Results: No replication of the CMV or other β-herpes viridae has been detected in any of the samples collected. Conclusions: The results strongly support the hypothesis that CMV is not the triggering factor in AA, neither as a re-activator of the immune response nor as a trigger of the autoimmunity. No other herpes virus is implicated in the pathogenesis of this disease.