ABSTRACT
Tonsillar tuberculosis is the infectious localization of Koch's bacillus in the palatine tonsils. It is rare. Tonsillar tuberculosis associated with miliary tuberculosis is even more exceptional. Objective: The aim of our work is to report a rare case of tuberculous tonsillitis associated with miliary tuberculosis. Patient and methods: This was a case of tonsillar tuberculosis associated with miliary tuberculosis. The main complaint was chronic odynophagia, which had been present for 7 months and was associated with weight loss. Questioning also revealed alcohol, tobacco and marijuana consumption. Results: Oropharyngoscopy revealed an enlarged, ulcerated and hemorrhagic right tonsil, suggesting a malignant lesion. Diagnostic tonsillectomy with anatomopathological examination of the surgical specimen led to the diagnosis of tonsillar tuberculosis. A postoperative chest X-ray revealed tuberculous miliaria. No other tuberculosis site was identified. No other confirmatory biological tests were carried out. The patient was treated with 4 anti-tuberculosis drugs (rifampicin, isoniazid, pyrazinamide, ethambutol) during 2 months and 2 anti-tuberculosis drugs (Rifampicin, Isoniazid) during 4 months. The evolution was favorable and the patient was declared cured at the end of treatment. There was no recurrence after 5 years. Conclusion: Tonsillar tuberculosis is rare. Tonsillar tuberculosis associated with pulmonary miliaria is even more exceptional. Tonsil biopsy for anatomopathological examination is sufficient for diagnosis. A chest X-ray should be requested as part of the preoperative workup prior to any tonsillar biopsy or tonsillectomy. GeneXpert (MTB/RIF) should be carried out if possible, not only for its value in the biological confirmation of tuberculosis but also to identify rifampicin resistance. Antibacillary treatment often leads to a favorable outcome.
Subject(s)
Palatine Tonsil , Tuberculosis, Miliary , Humans , Palatine Tonsil/pathology , Rifampin , Isoniazid , Tuberculosis, Miliary/drug therapy , Burkina Faso , Antitubercular Agents/therapeutic useABSTRACT
Objective: To report on a case of rare giant anterior cervical lipoma. Patients and methods: This was a 60-year-old male patient received in March 2020 for an anterior cervical swelling in progressive evolution since 20 years. The condition was negatively impacting the patient's quality of life with a feeling of cervical heaviness, discomfort, head movement limitations, with no sign of compression. Despite this significant discomfort, the patient first consulted several traditional practitioners with different traditional treatments without success, the mass having been taken for a goiter. It is in the face of the failure of traditherapeuts that the patient finally decided to consult in our care structure. Results: Physical examination found a large left paramedian formation which appeared soft, mobile vis-a-vis the two plans, and sensitive; it measured 13 cm on its longer axis, and surrounding skin showed scarifications, witness to previous traditional treatments. Cervical CT eliminated goiter and made it possible to diagnose a giant cervical lipoma. A cervicotomy was performed under general anesthesia with a total one-block excision of an encapsulated mass. The evolution was favorable with a good healing. The histological examination of the mass identified a well-differentiated lipoma. There was no relapse up until 24 months later. Conclusion: The giant anterior cervical lipoma is rare. The differential diagnosis is mainly posed with a large goiter or liposarcoma. CT or MRI make it possible to confirm the diagnosis. Its treatment is exclusively surgical and the examination of the operative piece by the pathologist confirms the diagnosis. An extended post-operative monitoring is recommended given the risks of relapse and of malignant degeneration.
Subject(s)
Lipoma , Burkina Faso , Diagnosis, Differential , Goiter , Humans , Lipoma/diagnosis , Male , Middle Aged , Neoplasm Recurrence, Local , Quality of LifeABSTRACT
Fibratosis colli, or infantile pseudotumor of the sternocleidomastoid muscle, is a rare cause of benign cervical mass in newborns and infants. This study involved all patients admitted with cervical swelling and diagnosed with colli fibromatosis from March 2016 to February 2020. Five patients were retained. In all patients cervical swelling occurred in the first month of life. No patient had had obstetric trauma. The diagnosis of fibromatosis colli was based on ultrasound. All patients received medical treatment. Fibratosis colli is a relatively rare cause of cervical mass in newborns and infants.
Subject(s)
Fibroma/diagnostic imaging , Head and Neck Neoplasms/diagnostic imaging , Muscle Neoplasms/diagnostic imaging , Neck Muscles/diagnostic imaging , Female , Fibroma/pathology , Head and Neck Neoplasms/pathology , Humans , Infant , Male , Muscle Neoplasms/pathology , Neck Muscles/pathology , UltrasonographyABSTRACT
Extremely serious diseases associated with very poor prognosis, especially in this context of undermedicalization and poverty. The aim of this case study was to determine the etiologies of these emergencies and to discuss their therapeutic management. Retrospective-descriptive study conducted over a 5-year period, a total of 52 clinical records were included. These infections accounted for 0.33% of our consultations. The average age of our patients was 23 years. Young age, inappropriate treatments and some ENT disorders were found to be contributing factors. The reasons for consultation were varied, depending on the site of infection; however, two clinical signs were constant: pain and fever. Adenophlegmon, peritonsillar phlegmon, cellulitis were our main etiologies together with streptococcus and staphylococcus which were the commonest causative bacteria. Empirical antibiotic therapy was used as first-line therapy, in particular third-generation cephalosporin + aminoglycoside + imidazole combination. Clinical course was marked by local and systemic complications. The evolution of diagnostic and therapeutic ENT emergencies management plans still encounters complications due to patient delay in seeking consultation.
Subject(s)
Bacterial Infections/epidemiology , Emergencies , Infections/epidemiology , Otorhinolaryngologic Diseases/epidemiology , Adolescent , Adult , Aged , Anti-Bacterial Agents/administration & dosage , Bacterial Infections/drug therapy , Bacterial Infections/microbiology , Child , Child, Preschool , Female , Humans , Infant , Infections/drug therapy , Infections/microbiology , Male , Middle Aged , Otorhinolaryngologic Diseases/drug therapy , Otorhinolaryngologic Diseases/microbiology , Retrospective Studies , Young AdultABSTRACT
But: Analyser les aspects epidemiologiques; diagnostiques et therapeutiques des sinusites chroniques de la face. Methode: Il s'est agit d'une etude retrospective de 05 ans; portant sur 365 cas de sinusites chroniques. Resultats: L'incidence annuelle etait de 73 cas/an et l'age moyen de 33 ans. Les principaux motifs de consultation etaient les cephalees (80;80); l'obstruction nasale (34;79) et la rhinorrhee (19;72). Les sinus maxillaires (96;44) et ethmoidaux (60;39) etaient les plus touches et les facteurs etiologiques etaient domines par les allergies naso-sinusiennes (73;15); les infections aero-digestives (19;18) et les blocages ostiaux mecaniques (7;67). Le traitement; medical (79;45) et medico-chirurgical (20;55) a permis d'obtenir une evolution favorable (90;96). Les complications ont ete observees dans 5;75 avec un taux de letalite de 1;92
