[Pseudo-tumoral invasive fungus infection of the maxillary sinus in Abidjan]. / Infection invasive à champignon filamenteux pseudotumorale du sinus maxillaire à Abidjan.

INTRODUCTION: The invasive fungal infection of the maxillary sinus is a rare and serious disease generally favored by immunosuppression. We report an exceptional case of pseudotumoral invasive fungal infection of the maxillary sinus in an immunocompetent patient. OBSERVATION: A 32-year-old patient consulted for labial and left temporal swelling associated with proptosis and chemosis that has been developing for 18 months. The scanner objectified a filling of the left maxillary sinus, and the ipsilateral orbital cavity, and the surrounding muscles. Histological examination of the surgical specimen revealed invasive fungal infection of the left maxillary sinus. The relevant antifungal therapy, namely voriconazole, could not be administered due to the unavailability of the medicine. However, the patient has received 200mg of itraconazole every 12hours for three weeks. The change proved disappointing with recurrence and significant sequelae, sort of sagging of the right hemifacial, severe limitation of mouth opening and functional loss of the right eye. CONCLUSION: The invasive fungus infections of the maxillary sinus and the orbit are exceptional in immunocompetent patient. Healing is based on early diagnosis and administration of the reference antifungal to face the risk of recurrence.

[Three new cases of visceral leishmaniasis in Côte d'Ivoire]. / Trois nouveaux cas de leishmaniose viscérale autochtone en Côte d'Ivoire.

The objective of this work is to report three cases of visceral leishmaniasis in non-HIV infected native patients in Côte d'Ivoire. The three observations concerned adults aged of 31 and 65 and a five years old child without particular medical or surgery histories. Factors associated with visceral leishmaniasis regarding the younger and the older adults were respectively young age, chronic lymphoid leukaemia and Burkitt lymphoma. Clinical features in the three cases were chronic fever a myeloproliferative syndrome with wasting syndrome and pancytopenia. The diagnosis was confirmed by the existence of Leishmania in bone marrow, ganglionic juice and splenic samples. The species of Leishmania was not identified. Specific treatment was based on intravenous amphotericin B (Fungizone) relayed by Glucantim in one case because of side effects; however the treatment has been unsuccessful. These three new cases show that visceral leishmaniasis is a reality in Côte d'Ivoire therefore an epidemiological survey is requested in order to identify Leishmania species, reservoirs and vectors.