Breast tuberculosis: A forgotten diagnosis.

Breast tuberculosis is a rare entity even in endemic countries. It is often considered as a diagnostic conundrum given the non-specific clinical and imaging characteristics. Therefore, the definitive diagnosis is based on the identification of bacilli by microbiological or histopathological examination. We report the case of a 52-year-old woman, with a 2-month history of a painful lump of the left breast. The imaging features were consistent with a breast abscess. The purulent collection was aspirated and a tuberculous mammary abscess was diagnosed by molecular biology (GeneXpert). Through this observation, we discuss the clinical, radiological and biological signs by highlighting the contribution of molecular biology in the rapid management of this rare pathology.

[Pseudo-tumoral Aspergillus rhinosinusitis of dental origin]. / Sinusite aspergillaire d'origine dentaire dans sa forme pseudo-tumorale.

INTRODUCTION: Sinonasal aspergillosis is caused by the interaction between the sinonasal mucosa with a cosmopolite fungus (Aspergillus), it is on the increase, this is an infection whose evolution is unpredictable requiring early diagnosis and appropriate support. We report a case of Aspergillus rhinosinusitis of dental origin in pseudo-tumoral form with a review of the literature. CLINICAL CASE: A 31 years-old, women, consulted for a right nasal obstruction with purulent rhinorrhea after dental treatment. On examination, there was a bulge of the inner canthus of the right eye and a mass in the right nasal cavity. The CT scanner showed a process of the left naso-sinus cavity centered by calcic image density. The patient underwent a total excision of the mass endoscopically. Mycological and pathological examination concluded that the etiology was Aspergillus fumigatus. The patient had not received any antifungal treatment. The postoperative course was uneventful. The evolution was favourable with no recurrence after 9 months. DISCUSSION: Aspergillus rhinosinusitis of dental origin is usually due to the emergence of canalicular filling paste into the maxillary sinus through and oral cavity and sinus fistula, neglected it can progress to invasive pseudo-tumoral form. The clinical presentation is nonspecific and the diagnosis often involves imaging (scanner). Mycological and histological examinations are essential for diagnosis. The treatment is based on surgery sometimes associated with antifungal treatment.

[Pneumomediastinum: an aspect of pulmonary barotrauma during mechanical ventilation of acute respiratory distress syndrome]. / Le pneumomédiastin : un aspect du barotraumatisme pulmonaire au cours de la ventilation mécanique du syndrome de détresse respiratoire aiguë

Mechanical ventilation is a fundamental treatment of acute respiratory distress syndrome (ARDS). Despite compliance with the recommendations of protective mechanical ventilation, it can results in serious complications including the pulmonary barotrauma. This is often manifested by a pneumothorax. This observation describes an unusual aspect of barotrauma which is pneumomediastinum. The authors also point out the role of chest imaging in the management of mechanical ventilation during ARDS.

[Tumoral calcinosis: a case report]. / La calcinose tumorale: à propos d'un cas.

Tumoral calcinosis is a rare benign disease, defined by the presence of calcified deposits in periarticular tissues. The pathogenesis is unclear. We report a new case of tumoral calcinosis in a young girl, involving the left hip and both elbows. The clinical exam found a voluminous mass of soft tissues and the radiological exam showed the presence of voluminous periarticular calcifications with no bone involvement. The diagnosis was confirmed by the anatomopathological exam. The treatment remains essentially surgical and the prognosis is very good.