A Case of Lagochilascariasis in Suriname with the Involvement of the ENT System and the Skull Base.

We describe a case of human lagochilascariasis, with skull-base involvement and a chronic and relapsing course after treatment. This rare parasitic infection is usually manifested in the head and neck area, characterized by progressive granulomatous inflammation and the formation of abscesses. Transmission to humans most likely occurs by the consumption of undercooked meat of wild rodents. On the basis of literature studies, we propose the most likely life cycle of the parasite that involves wild feline and rodent species, with humans as accidental hosts. Even in endemic areas, it is very difficult to recognize the disease at an early stage. Progression will eventually lead to involvement of the (central) nervous system, as described in our case. Treatment is often difficult and involves resection and prolonged treatment with anthelmintic drugs. Recurrences are not uncommon and at present, long-term oral administration of ivermectin seems to be the most effective treatment.

[Cystic neck mass. Cervical cleft cyst or lymph node metastasis?]. / Cysteuze zwelling in de hals. Laterale halscyste of lymfekliermetastase?

While most cystic neck masses are cervical cleft cysts, it is known that lymph node metastasis from a squamous cell carcinoma in Waldeyer's ring may undergo cystic degeneration and can mimic cervical cysts, leading to a mistaken diagnosis. A 54-year-old male presented with features of a cervical cleft cyst, which later proved to be a lymph node metastasis from a supraglottic laryngeal carcinoma. A 47-year-old male presented with an abscessing lymphadenitis; this turned out to be a metastasis of an unknown primary tumor. Investigations should include ultrasound-guided FNA (fine-needle aspiration) performed by an experienced radiologist. However, FNA outcomes are often inconclusive. In patients who are highly suspected of having a malignancy (those with a history of smoking and alcohol abuse), a panendoscopy with biopsies and tonsillectomy, preferably conducted by an otolaryngologist specialised in head and neck cancer, should be considered.

Epidemiology of cutaneous leishmaniasis in Suriname: a study performed in 2006.

Cutaneous leishmaniasis (CL) is a widespread disease in Suriname caused by Leishmania Viannia guyanensis. It is argued that other Leishmania species are also responsible for CL and that the incidence is increasing. This study aimed to identify the species causing the disease and to estimate the annual detection rate of CL in Suriname in 2006. In Paramaribo, 152 patients were registered, of whom 33 were tested in two polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP) methods. Twenty-seven patients were infected with L. (V.) guyanensis (complex), one with L. (V.) lainsoni, and one with L. (Leishmania) amazonensis. In the hinterland, 162 CL suspected patients were registered by questionnaires; of these, 24 of 27 tested positive by PCR-RFLP (88.9%; 95% CI, 77.1-100%). With extrapolation of collected data, a detection rate was calculated of 5.32 to 6.13 CL patients per 1,000 inhabitants for the hinterland and 0.64 to 0.74 patients per 1,000 inhabitants for the whole country.