[Congenital corneal anesthesia. A case report]. / Anesthesie corneenne congenitale: a propos d'un cas.

Congenital corneal anesthesia (CCA) is an uncommon condition difficult to diagnose. We report the case of a 4-year-old girl who presented with bilateral congenital corneal anesthesia revealed by a corneal ulcer which had been unresponsive to adapted local treatment. Self-inflicted corneal injuries were present. It is important to search for corneal anesthesia in children with chronic ulceration of the cornea and selfinflicted injuries.

[Primary extranodal ENT tuberculosis]. / La tuberculose primitive ORL extraganglionnaire.

OBJECTIVES: The aim of this sinusonasal study was to study several locations of ENT extranodal tuberculosis. MATERIAL AND METHODS: Our study focused on eight cases of tuberculosis in the cervicofacial region gathered in the ENT department of the Rabat Specialization Hospital (Morocco) between August 2004 and August 2006. They comprise two cases of rhinopharyngeal tuberculosis, two cases of tuberculosis, two cases of endobuccal tuberculosis (mandibular and lingual locations), and two cases of glandular tuberculosis (thyroid and parotid locations). RESULTS: These locations are rarely affected by tuberculosis. The clinical signs as well as radiology and endoscopy are not specific. The final diagnosis is based on histology. Bacillus cultures are necessary when caseum tuberculosis is not found, causing problems of differential diagnosis with granulomatous and malignant lesions. PCR provides quick bacterial antigen detection when cultures are negative. The treatment provides a quick and complete recovery while recurrences are infrequent. CONCLUSION: ENT tuberculosis is rare if excluding the nodal locations. It should be mentioned as a differential diagnosis, especially in endemic areas. Most often, this is a surprise diagnosis.

Cervicofacial cellulitis: The impact of non-steroidal anti-inflammatory drugs. A study of 70 cases.

INTRODUCTION: Cervicofacial cellulitis (CFC) is a severe infection of the subcutaneous cellular tissue, and is one of the most serious head and neck infectious emergencies. In a series of 70 cases treated between 2007 and 2012, we noticed a strong correlation between use of non-steroidal anti-inflammatory drugs (NSAIDs) and evolution of head and neck infections toward CFC, including two cases of necrotic CFC extending to the mediastinum, which were fatal. MATERIAL AND METHODS: The cases included in the series comprised patients admitted to emergency and requiring hospitalization due to the severity of presenting symptoms. There were 70 such cases of CFC between 2007 and 2012; cases managed on an outpatient basis were excluded, as were cases of orbital CFC, CFC of sinus origin and mastoiditis. RESULTS: Eighty percent of patients took NSAIDs, on self-medication or by prescription (community physician, dentist, pharmacist). The most frequent molecules were tiaprofenic acid and diclofenac. CFC extension was restricted in most cases to the maxillary and/or ipsilateral subhyoid region, with 5 cases of lower cervical extension and 2 of mediastinal involvement, which both proved fatal. CONCLUSION: CFC is a severe infection that can be life-threatening, and represents a diagnostic and therapeutic emergency. Among other risk factors, use of NSAIDs is frequently reported; these should therefore be used with caution if at all in head and neck infection, especially of odonto-stomatological origin.

[Ear, nose and throat pathology in human immunodeficiency virus infection]. / Pathologie de la sphère ORL au cours de l'infection par le virus de i'immunodéficience humaine.

Human immunodeficiency virus (HIV) infection, which is responsible for AIDS, is one of the most widespread in the world. Its clinical manifestations are polymorphous, and are casued by the virus itself (primary lesions) or the resulting immunodepression (secondary lesions). All the body can be affected, and the ORL organs are frequently involved. Our purpose was to describe these manifestations at all stages of the disease, and to illustrate the importance of an early diagnosis, which needs close collaboration between the clinician, the anatomopathologist and the radiologist.

[Secondary malignant tumors of the parotid area]. / Les tumeurs malignes secondaires de la région parotidienne.

Secondary malignant tumors of the parotid gland are uncommon. They arise from primary tumors located in the head and neck or from distant primary tumors. The formers are dominated by squamous cell carcinomas and melanomas, the latters by kidney and bronchic cancers. Distinction between malignant primary tumors and metastasis of other primary tumors to the parotid gland is very important to appreciate, because the result of this will change therapeutic procedure and the evaluation of prognosis. The rarity of this metastatic site is illustrated by this series of 9 cases. These observations raised discussion about the site of the primary tumor, the localization in the parenchyma or in the lymph nodes, and the histological differential diagnosis.

Purification of soluble specific antigens of systemic candidiasis by antibody affinity chromatography.

Serological methods can be applied to the diagnosis of systemic candidiasis, but cell wall mannans can detect antibodies occurring in several cases unrelated to candidiasis. The present study proposes a procedure for the preparation of specific antigens obtained from an experimental infectious model. The specific immunoglobulins were obtained from rabbits with chronic systemic candidiasis. After precipitation by ammonium sulfate and purification by ion-exchange chromatography on DEAE-Sephadex A-50, these immunoglobulins were fixed on cyanogen bromide-activated Sepharose 4B and used for the preparation of an affinity chromatography column. This column allowed isolation of specifically bound fractions of Candida albicans soluble antigens. When analyzed by quantitative immunoelectrophoresis with a polyvalent hyperimmune antiserum, these fractions showed eight precipitation lines, whereas the complete soluble antigen exhibited 48 lines. Possible applications of these antigens to specific serodiagnosis of systemic candidiasis are being evaluated.