Visceral Leishmaniasis (VL) disease, endemic to Algeria, is a major public health problem for children from rural areas and suffering from malnutrition, this disease currently tends to decrease. However, we found a constant progression in adults over the last twenty years. Indeed, 64 cases of VL in adults were recorded between 1991 and 2010 in Kabylia (Tizi-Ouzou, Bejaia and Bouira) with 18 cases with VL/HIV co-infections. Co-infected men is predominant with 15 cases, a sex ratio of 5 and an average age 35.57 +/- 2.3 years. Typical clinical signs, namely; fever, splenomegaly and hepatomegaly are observed only in 22.2% of the cases; absence of fever (n=4), splenomegaly (n=2), two (n=2) and presence lymphadenopathy (n=5). We also noted the presence of risk factors such as the advanced age of patients and late diagnosis of visceral leishmaniasis usually associated with the advanced stages of HIV infection (III, IV) in mostly multi-infected patients. We also identified five (5) cases of shingles and four (4) cases of digestive candidacies who were the most opportunistic infections observed in our series. Pancytopenia, observed in 2/3 of the cases has been the most consistent biological sign and contributing in the evocation of the VL as the clinical presentation was atypical. The confirmation, by direct examination of bone marrow smears by identifying amastigotes, is observed in all HIV patients (PVIH). Western blot and PCR techniques have allowed better monitoring of patients. In 5 cases, the VL revealed the infection of HIV. The care was difficult because of the numerous observed relapses. The unavailability of Amphotericin B, inherent in different factors, compelled us, in some situations, to use the Glucantime as first-line treatment (n=4). Prophylactic treatment based on Pentamidine (n=2), Glucantime (n=2) and amphotericin B (n=12). The evolution was marked by 5 deaths during the first days of treatment anti-Leishmanial and one after several relapses were observed as well as a resistance perhaps to Glucantime resulting in splenectomy.
Our study aimed at assessing the role of Coxiella burnetii in nonspecific febrile illness at the National Center of Infectious Diseases in Algeria, EL-HADI FLICI Hospital. Seventy patients were included and compared to seventy controls without any ongoing infection. Coxiella burnetii infection was investigated using IFA serology and qPCR. Serology was positive in 3 of 70 patients (4.30%), including 1 in whom PCR was also positive (1.42%). All three patients reported frequent contact with ruminants. These results suggest that C. burnetii is an agent of nonspecific febrile illness in Algeria.
Introduction:The advent of antiretrovirals has reduced the prevalence of neuroméningated cryptococcosis (CNS) in patients living with HIV (PLHIV).Objectives: Epidemiological-clinical, paraclinical, therapeutic and evolutionary analysis of 54 cases of CNM in PVVIH. Patients and methods:A retrospective study reporting cases of CNM in patients living with HIV (PLWHIV) collected between January 01, 1993 and June 30, 2017 at the national reference center for the management of HIV infection; EHS service B El Hadi Flici ex EL KETTAR, Algiers. Results:In a group of 1289 PPVIH, 4.2% presented a CNM.The mean age was 39 ± 2years with a sex ratio of (3.15).The CNM was inaugural of HIV infection in 41%.The dominant picture: meningoencephalitis in 50% of cases, febrile headache 28%, fevers isolated 11%, headache isolated 9% and one asymptomatic case.The stiffness of the neck found in fourteen patients.Note that 04 patients developed disseminated form.In 51 lumbar punctures performed, the cephalospinal fluid (LCS) was pathological in 61%, with a clear appearance of 86%.Mean cytoracy: 60 cells / mm3 predominantly lymphocytic in 19 patients.Hyperproteinorachia was found in 18 patients with an average of 0.73 g / l.Hypoglycorachia in 14 patients with an average of 0.36 g/l.direct examination with Indian ink staining identifies Cryptococcus neoformans in 61% of cases, culture on Sabouraud medium supplemented with chloramphenicol positive 80.3%.The search for soluble cryptococcal antigens by the latex agglutination test was positive in 70.6%.In the context of the dissemination report: 63% positive antigenemia, two positive blood cultures, two antigenurias and direct urine tests for cryptococcus were positive, and a skin biopsy performed in one patient was positive.In the induction phase, amphotericin B was prescribed as monotherapy in 87% of cases whereas fluconazole was only prescribed in 7.4% (n = 4)
Undeniably, infectious diseases remain the sphere the most important in the recent decades.The balance between old and new infections, has never tilted to one side.Constantly, new infections diseases appear, and the old ones emerge.Through the studied past, 75% of the re-emerging infectious diseases are zoonosis.This fact may be linked to the high sensitive relationship between Host-Pathogen, which are knowing several phenotypical and genotypic changes, thus acquiring new characteristics and arise in unexpected environments or food vehicles.All these changes, may be caused by climate shifts, and their environmental impacts on biodiversity that has affected the howl world.
