Multiple pelvic and thigh hydatid cyst: a case report.

Bone cystic echinococcosis is rare disease and its management remain difficult to treat due to frequent recurrences, related to certain locations such as proximal femur and ilium, where radical surgery is difficult to achieve. Medical therapy using Mebendazol can be an ultimate way to insure stabilization and remission of the parasitosis. We present a case of a 37-year-old male who had complaints of pain in left hip and limp four years after surgical management of pertrochanteric fracture of his right lower limb. The first clinical and radiological diagnosis was osteoarthritis of proximal femur and hip. However, higher imaging modalities revealed the diagnosis of hydatid disease of hip with extensive pelvic hydatid cyst localizations. The patient underwent anthelminthic chemotherapy. At 7 years follow-up, the lesions remains stable and the patient has tolerate hip pain, support and walking are impossible without crutches. Hydatid disease of the proximal femur and pelvis must be kept in mind in the differential diagnosis of pathologies of hip-like septic arthritis or tuberculosis. Prolonged medical therapy with anthelmintic medications can constitute an alternative to surgery at very high risk and for extensive lesions where surgery can not achieve carcinologic goals.

[Candida famata candidemia in immunosuppressed patient: report of a case with literature review]. / Candidémie à Candida famata chez un patient immunodéprimé: à propos d'un cas et revue de littérature.

Candida Famata is an opportunistic pathogen. Very rare cases of candidemia Candida Famata have been described. We report a case of a patient of 16 years undergoing chemotherapy for Hodgkin's disease. The patient was put under voriconazole for 3 weeks with a good evolution. This case confirms the opportunistic pathogen Candida Famata. All insulation in the blood must be considered before a background of immunosuppression.

Invasive Aspergillus terreus sinusitis with orbitocranial extension: case report.

BACKGROUND: Aspergillosis of the paranasal sinuses is infrequent and usually involves the species Aspergillus fumigatus and A. flavus. The maxillary sinus is the most common sinus to be affected. Invasive cranio-orbital aspergillosis originating in the sphenoid sinus is rare and mostly occurs in immunocompromised patients with poor outcomes. We present a case of invasive A. terreus sphenoidal sinusitis with intraorbital and intracranial extension in an immunocompetent patient. CASE DESCRIPTION: This 62-year-old man presented with a 2-month history of left retroorbital pain followed by rapid decreasing vision and 2 episodes of epistaxis. Ophthalmologic examination revealed no light perception left. Computed tomographic scan and MR images demonstrated an enhanced sphenoid lesion within the left sphenoid sinus with bone destruction and intraorbital and cavernous sinus extensions. A malignant tumor was suspected. The patient underwent a transphenoidal biopsy of the sphenoid mass. Histologic analysis revealed numerous Aspergillus hyphea, and the species A. terreus was isolated from fungal cultures of specimens. No systemic fungal infection was found, and the patient had no evidence of immunosuppression. After 3 months' administration of oral voriconazole, the patient became well, and the orbitocranial mass regressed in size. It was stabilized on the ninth postoperative month. CONCLUSION: A. terreus sinusitis with orbitocranial extension had never been reported in the literature. Even in an immunocompetent host, ISOA is difficult to eradicate using surgical debridement combined with optimal antifungal agents because of the intracranial extension and the relative resistance of conventional antifungal therapy. Early diagnosis is important to prevent an unfavorable outcome of this emergent infection.