[Multifocal tuberculosis simulating multimetastatic colon cancer in an immunocompetent black African patient: a case report]. / Tuberculose multifocale simulant un cancer du côlon multi-métastatique chez un Noir africain immunocompétent: à propos d´un cas.

Multifocal tuberculosis is rare in immunocompetent subjects. It is characterized by the involvement of at least two extra-pulmonary sites, associated or not with lung disease. It is often difficult to diagnose. We here report a case of multifocal tuberculosis in a non-immunocompromised black African subject at the Hubert Koutoukou Maga National Hospital and University Center (CNHU-HKM) in Cotonou, Benin. The study involved a 23-year-old man, with no particular previous history, admitted with diffuse abdominal pain associated with alteration of general state. Clinical examination showed severe malnutrition and medium-volume ascites. Imaging tests (chest X-ray, ultrasound and computed tomography (CT) scan) showed multiple lung, liver, pancreatic, bone, lymph nodes and colic lesions suggesting multimetastatic tumor. Colonoscopy then showed budding lesion of the cecum. GeneXpert test showed Koch´s bacilli. The anatomo-pathological examination of colic biopsies and GeneXpert sputum test confirmed multifocal tuberculosis. The patient received antituberculosis treatment and nutritional support. However he died. Multifocal tuberculosis is a serious disease that is difficult to diagnose. Then it is frequently mis-diagnosed in tropical areas, especially when it occurs in immunocompetent patients.

Ultrasound diagnosis of varicocele in the adolescent: our experience from Benin.

BACKGROUND: The diagnosis of varicocèle is clinical. In order to improve diagnosis of varicocele, we compared the clinical with the ultrasound findings in schoolboys with the condition. This is because the conditions can affect testicular growth. PATIENTS AND METHODS: It was a cross-sectional, descriptive study of schoolboys aged from 10 to 19 years who had varicocele. Among 2724 boys examined, 149 had varicocele and only 81 had scrotal (18 with Doppler) and renal ultrasound examination. RESULTS: Among the 81 adolescents who were clinically diagnosed with varicocele and also with the aid of ultrasound scan, 25, 36 and 20 had grade 1, 2 and 3, respectively. Testicular hypotrophy (TH) was clinically noticed in 17 cases. At ultrasonography, varicocele was bilateral in 87.66% and unilateral in 12.34% (P = 0.01) with 32 adolescents (39.51%) showing TH compared with 20.99% being diagnosed with TH using clinical examination alone (P = 0.01). In 50 schoolboys (61.73%) with unilateral varicocele, a subclinical type was discovered at other side. Renal ultrasound revealed abnormalities in 4.93% of cases. Doppler ultrasound helped in finding varicoceles along the top edge of the testis (n = 15) and under tunica albuginea (n = 3). CONCLUSION: TH due to varicocele is better studied by ultrasound.