One of the uncommon benign parotid gland pathologies is benign lymphoepithelial cysts. It is a progressively growing cystic lesion that is frequently linked to HIV infection, also its occurrence has grown recently due to the rise in AIDS patients. Rarely, immunocompetent patients may exhibit it. This is an example of an uncommon case of parotid gland BLEC in seronegative patient. A preoperative diagnosis can be obtained through appropriate medical history, physical examination, radiography, and fine needle aspiration. Histopathology, however, aids in ruling out alternative scenarios. The most effective treatment option with fewer recurrence rates is surgical excision. Therefore, when a patient has a lymphoepithelial cyst, surgeons should be concerned about HIV infection.
Background Extratemporal facial nerve injuries caused by penetrating cervical trauma are uncommon and often underestimated due to minimal external lesions. Early recognition and prompt management are essential to optimize functional recovery. Case Presentation We report the case of a 17-year-old male admitted for a left retroauricular stab wound. The initial evaluation revealed no major vascular or osseous injuries. Upon further examination, a complete immediate peripheral facial paralysis (House–Brackmann grade VI) was identified. Temporal bone Computed Tomography (CT) imaging was performed to evaluate the intertemporal portion of the facial nerve. Given the immediate onset of paralysis, urgent surgical exploration was undertaken without prior electrodiagnostic testing, in accordance with current recommendations suggesting early repair when transection is suspected. Intraoperatively, the proximal and distal segments of the facial nerve were identified at the stylomastoid foramen and within the upper cervical region, respectively, and were repaired by end-to-end micro suturing. Postoperative management included corticosteroid therapy, vitamin supplementation, ocular protection, and early physiotherapy. At 3-month follow-up, the patient showed partial recovery (House–Brackmann grade III), consistent with published outcomes following timely nerve repair. Conclusion This case highlights the importance of careful clinical assessment in penetrating cervical trauma, even when wounds appear minor. Immediate complete facial paralysis strongly suggests nerve transection and warrants early surgical intervention. Prompt management can result in favorable outcomes.
Backgrounds Ectopic thyroid tissue is a rare developmental anomaly resulting from abnormal migration of thyroid tissue during embryogenesis. It is most frequently encountered along the midline thyroglossal tract, whereas lateral cervical localization remains exceptional. In such cases, imaging findings may mimic hypervascular cervical tumors, particularly carotid paragangliomas, leading to diagnostic challenges. Case Presentation We report the case of a 49-year-old woman with a history of total thyroidectomy performed four years earlier for benign multinodular goiter, who presented with a progressively enlarging left laterocervical mass evolving over one year. Cervical ultrasonography demonstrated a heterogeneous lesion measuring 36 × 28 × 15 mm in the left level II region associated with an empty thyroid bed. Contrast-enhanced computed tomography revealed a well-circumscribed hypervascular mass highly suggestive of a carotid paraganglioma. Complete surgical excision was performed. Histopathological examination revealed dystrophic ectopic thyroid tissue without evidence of malignancy. Conclusion Lateral cervical ectopic thyroid tissue is an uncommon entity that may closely simulate carotid paraganglioma on radiological evaluation. This case highlights the importance of considering ectopic thyroid tissue in the differential diagnosis of lateral neck masses, even in patients with previous thyroidectomy, in order to establish an accurate diagnosis and guide appropriate management.
Background: Psychotropic medications are widely prescribed for chronic psychiatric disorders and constitute an essential component of modern psychiatric management. Although their systemic adverse effects have been extensively investigated, ocular toxicity remains insufficiently characterized. Phenothiazines have historically been implicated in lens opacities, while the association between newer psychotropic agents and cataract formation remains controversial. Objective: To describe a series of patients presenting with early cataract under chronic psychotropic treatment and to critically review the available literature regarding the potential role of psychotropic medications in cataractogenesis. Methods: A descriptive observational study was conducted involving 12 psychiatric patients receiving long-term psychotropic therapy who presented with progressive visual impairment. Demographic characteristics, psychiatric diagnoses, duration and type of psychotropic exposure, cataract morphology, and associated risk factors were analyzed. Results: The median age was 52 years and the female-to-male ratio was 1.4. The average duration of psychotropic exposure was five years. The most frequently prescribed medications were levomepromazine, olanzapine, and fluoxetine, administered either alone or in combination. Ophthalmological examination revealed posterior subcapsular cataracts, cortico-nuclear cataracts, and total white cataracts. No major conventional cataract risk factors were identified in most patients. Conclusion: Our findings support the hypothesis that chronic exposure to psychotropic medications may contribute to accelerated cataractogenesis. Regular ophthalmological monitoring should be considered in patients receiving long-term psychotropic therapy. Further prospective studies are required to establish causality.
Introduction : Les corticoïdes sont prescrits comme adjuvants dans certaines infections cérébro-méningées pour réduire la réponse inflammatoire. Les recommandations internationales précisent la molécule, la posologie et la durée du traitement selon l’étiologie. L’objectif de cette étude était d’évaluer la conformité des prescriptions de corticoïdes aux recommandations internationales dans le service des maladies infectieuses du CHU IBN Rochd de Casablanca. Matériel et méthodes : Il s’agit d’une étude transversale descriptive monocentrique sur un an (du 1er janvier au 31 décembre 2023). Ont été inclus tous les patients hospitalisés pour une infection cérébrale et/ou méningée ayant reçu une corticothérapie. Les dossiers incomplets ont été exclus. Les variables recueillies comprenaient données sociodémographiques, cliniques et thérapeutiques (molécule utilisée, voie d’administration, schéma posologique, durée, protocole d’arrêt et traitements adjuvants). La conformité de la corticothérapie a été évaluée par rapport aux recommandations IDSA, SPILF et OMS. Les données ont été traitées avec SPSS v.23. Résultats : Trente-neuf patients ont été inclus. L’âge moyen de nos patients était de 39,87±15,85 ans avec une prédominance masculine. Vingt-cinq patients, soit 64,1%, ne présentaient aucun antécédent pathologique. Vingt-cinq patients (64,1%) avaient reçu une corticothérapie parentérale et orale ; 25,64% une corticothérapie parentérale seule et 10,25% une corticothérapie orale seule. Méthylprednisolone est prescrite dans la quasi-totalité des cas (87,17%). Les schémas posologiques étaient hétérogènes et souvent prolongés. Une dégression de la corticothérapie a été effectuée chez 75,86% des patients. Une supplémentation en potassium et calcium a été prescrite chez 76,9% des patients et les IPP dans une proportion de 38,46% des cas. Au regard des recommandations, aucune prescription de corticothérapie ne remplissait l’intégralité des critères de conformité définis. Conclusion : Cette étude met en lumière des écarts considérables entre la prescription des corticoïdes et les recommandations internationales en termes de choix de la molécule, de la posologie, de la durée et du traitement adjuvants. Ces résultats soulignent la nécessité d’une actualisation des protocoles thérapeutiques et d’une formation continue des prescripteurs pour un meilleur usage des corticoïdes à l’hôpital. Introduction: Corticosteroids are prescribed as adjunctive therapy in certain cerebrospinal fluid infections to reduce the inflammatory response. International guidelines specify the molecule, dosage, and duration of treatment according to the etiology. The objective of this study was to evaluate the conformity of corticosteroid prescriptions to international recommendations in the infectious diseases department of the IBN Rochd University Hospital in Casablanca. Material and methods: This was a single-center, descriptive, cross-sectional study conducted over one year (January 1 to December 31, 2023). All patients hospitalized for cerebral and/or meningeal infection who received corticosteroid therapy were included. Incomplete records were excluded. Data collected included sociodemographic, clinical, and therapeutic information (drug used, route of administration, dosage regimen, duration, discontinuation protocol, and adjuvant treatments). Adherence to corticosteroid therapy was assessed against IDSA, FIDS, and WHO guidelines. Data were analyzed using SPSS v.23. Results: Thirty-nine patients were included. The mean age of our patients was 39.87 ± 15.85 years, with a male predominance. Twenty-five patients (64.1%) had no prior medical history. Twenty-five patients (64.1%) received parenteral and oral corticosteroid therapy; 25.64% received parenteral corticosteroid therapy alone, and 10.25% received oral corticosteroid therapy alone. Methylprednisolone was prescribed in almost all cases (87.17%). Dosage regimens were heterogeneous and often prolonged. Corticosteroid therapy was tapered in 75.86% of patients. Potassium and calcium supplementation were prescribed in 76.9% of patients, and proton pump inhibitors (PPIs) in 38.46% of cases. According to the guidelines, no corticosteroid prescription met all the defined compliance criteria. Conclusion: This study highlighted significant deviation between corticosteroid prescriptions and international recommendations regarding the choice of molecule, dosage, duration, and adjuvant treatment. These findings emphasize the need for updated local protocols and continuous prescriber training to ensure rational corticosteroid use in hospital settings.
