Fibrome ovarien géant : A propos d’un cas

le fibrome ovarien est une tumeur solide stromale du cordon sexuel de l'ovaire représentant 1 à 4% des tumeurs de l'ovaire.le fibrome ovarien est difficile à diagnostiqueren préopératoire et généralement pris pour un fibrome utérin en raison de l'échogénicité similaire des deux lésions. l'imagerie par raisonnance magnétique est plus performante que l'échographie pour confirmer la nature utérine ou ovarienne d'une masse solide latéro utérine gfrace au repérage de l'endomètre en T2. le traitement est l'éxèrèse chirurgicale et l'étude anatomopathologique permet de confirmer le diagnostic

Bone Marrow Infiltration in Rosai–Dorfman Disease

Rosai–Dorfman disease (RDD) is a rare and benign nonLangerhans cell histiocytosis. RDD commonly affects children and young adults typically presenting with massive, painless, and bilateral cervical lymphadenopathy. Extranodal involvement is present in about 40% of cases, and bone marrow infiltration is rare and unusual. RDD prognosis is usually good, however, involvement of bone marrow is associated with poor prognosis. We report a case of RDD with bone marrow involvement occurring in a 5-year-old female. She was admitted for asthenia, gingival bleeding, and diffuse bone pain without fever. Physical examination showed pallor, petechiae over the abdomen, painless and bilateral cervical lymphadenopathy, and several bony nodules, without splenomegaly or hepatomegaly. Cell blood count revealed microcytic hypochromic anemia with thrombocytopenia. Bone marrow aspiration showed infiltration by large histiocytes with hypochromatic nuclei and abundant vacuolated cytoplasm without emperipolesis. Biopsies of bone marrow, lymph node, and bone revealed immunohistochemical features of RDD: the histiocytes were positive for CD68 and S100 protein, but negative for CD1a. The patient initially received symptomatic treatment. One week after admission, she died of septic shock before the final establishment of RDD diagnosis. This case report highlights that bone marrow involvement in RDD is rare and associated with poor prognosis. We also aim to emphasize the obligation of bone marrow exploration in patients with RDD and presenting cytopenias in order to make an early diagnosis of bone marrow infiltration

Vancomycin-resistant Enterococcus faecium in an Immunocompromised Patient

Over the last decades, Vancomycin-resistant Enterococcus, namely Enterococcus faecium, has emerged worldwide as a dreaded nosocomial pathogen, particularly in immunocompromised patients. Vancomycin-resistant Enterococcus infections remain rare but threatening, leading to high mortality rates, primarily because of limited treatment options.We once reported a case of nosocomial bacteremia caused by vancomycin-resistant Enterococcus faecium in a patient with acute myeloid leukemia. During his hospitalization for chemotherapy, the patient presented febrile neutropenic episodes, and his blood culture grew Enterococcus faecium that was resistant to vancomycin with a minimum inhibitory concentration > 256 mg/L by the E-test. The polymerase chaine reaction amplification revealed the presence of the VanA/VanB genes, and the resistance to both vancomycin and teicoplanin is consistent with the VanA phenotype. The patient died before starting appropriate antibiotic treatment.This case report highlights the importance of early diagnosis of Vancomycin-resistant Enterococcus infections, particularly in patients with impaired host defenses, in order to ensure a rapid infection management. It is the first case of Vancomycin-resistant Enterococcus reported in our microbiology laboratory. We also aim to emphasize the need of strict measures to control the spread of Vancomycin-resistant Enterococcus strains.