Kikuchi-Fujimoto disease, a rare cause of lymphadenopathy in Africa. Description of the first case in Senegal and review of the literature.

INTRODUCTION: Kikuchi-Fujimoto disease, or histiocytic necrotizing lymphadenitis, is a benign disease most commonly affecting adult females. It generally presents in the form of febrile cervical lymphadenopathy. This diagnosis must be considered in the setting of tropical medicine, dominated by a high prevalence of tuberculous lymphadenitis and haematological malignancies. CASE REPORT: The authors report the case of a 33-year-old Senegalese woman who presented with subacute cervical lymphadenopathy associated with fever and laboratory signs of inflammation. Serological and tuberculosis screening tests were negative. Histopathological examination of a lymph node biopsy, following failure of nonspecific antibiotic therapy, concluded on a diagnosis of Kikuchi-Fujimoto disease. A favourable course was observed in response to corticosteroid therapy. CONCLUSION: In Sub-Saharan Africa, the association of polyadenitis and febrile syndrome, after excluding tuberculosis and lymphomas, must raise the suspicion of rare diseases such as Kikuchi-Fujimoto disease.

[Ameloblastomas]. / Les améloblastomes.

OBJECTIVES: The aim of this work was to report on the clinical, radiological and histological characteristics of ameloblastomas concerning bone structures of the face, rare but not exceptional tumours, and to communicate our experience of their treatment. MATERIAL AND METHODS: The authors reexamined six recent cases of patients presenting with ameloblastoma at the centre Antoine Lacassagne in Nice. The diagnostic context, the treatment and the development of the disease are given in detail, emphasizing the frequency of local relapse of this histologically benign condition. RESULTS: The study of these cases confirmed the benefit of surgical treatment of ameloblastoma. The frequency of local relapse in the cases of close resection, leaving in place micro-foci, justifies enlarged intervention, which is often bone destructive. CONCLUSION: When the continuity of the bone is interrupted, in particular at the level of the mandible, and if the general condition of the patient permits, repair is preferable. In this situation, the procedure of choice is micro-anastomosis of the fibula.

[Cranioencephalic complications of middle ear cholesteatoma: report of 4 cases]. / Complications infectieuses cranio-encephaliques de l'otite moyenne chronique cholesteatomateuse. A propos de 4 observations.

INTRODUCTION: Cranial and intracranial complications can be observed during middle ear cholesteatoma's evolution. We report our experience of management of infectious cholesteatoma's cranioencephalic complications. MATERIAL AND METHODS: In a three year period, we had consecutively admitted 4 patients with cranioencephalic complications of middle ear cholesteatoma, in the Ear Nose and Throat (ENT) department of the university teaching hospital of Dakar. After preoperative investigations with computed tomography scan (CT scan) of brain and temporal bone. The patients had been operated after paraclinic assessment. RESULTS: The finding showed one case of temporal bone otogenic extensive osteomyelitis with multifocal extradural empyema, 3 cases of brain abscess associated with subdural empyema and meningitis in 1 case. For 3 patients (75%), neurosurgical drainage and mastoidectomy were performed, associated with antibiotic treatment. The mastaidectomy was performed in the same time of the surgical procedure or delayed. One patient, with brain abscess, died before surgical intervention. With a follow up of 15 months, we have noticed stable mastoidectomies cavities and no neurological recurrence symptoms. CONCLUSION: These complications can be prevented by early treatment of chronic otitis media diseases. The appropriated management of these complications necessitate collaboration between otorhinolaryngologists and neuro surgeons.

[Subdural empyema complicating acute frontal sinusitis. Four cases report]. / Empyème sous-dural compliquant une sinusite frontale aiguë. A propos de 4 cas.

OBJECTIVE: Subdural empyema is a collected cranioencephalic suppuration between arachnoid and dura meninge space. Subdural empyema occurring after sinusitis is an uncommon but serious complication of paranasal sinus infections. The purpose of this study is to aware the clinician about this condition. MATERIAL ET METHOD: Four young male children had been admitted with expressed fronto-ethmoid sinusitis. The intracranial infection was confirmed by computed tomography scan of brain and sinus. Both drainage of the sinus and intracranial suppuration was performed at the same time surgical procedure and antibiotics administered during 4 weeks. RESULTS: The subdural empyema was localized in the right temporoparietal region in 1 case, in the frontal lobe in the others cases. In 1 case, the frontal subdural empyema was associated with an inerhemispherique collection. One patient underwent a second drainage. Immediate post-operative outcomes were temporally complicated with convulsions and focal neurological deficit, in 1 case. This symptoms had regressed spontaneously. There was no case of death. The functional prognosis was bad, marked by lost vision in 2 cases, which was bilateral in 1 case. CONCLUSION: A high index of suspicion of intracranial extension of sinus infection must recommended neuroradiological investigations. When suppurative collection is confirmed, an appropriated management of the infection between otorhinolaryngologists and neurosurgeons is necessary.