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Background: TIBOLA (tick-borne lymphadenopathy) is a rickettsiosis caused chiefly by R. slovaca, transmitted by a Dermacentor tick. We report five cases., Patients and Methods: Three patients were diagnosed at the initial inflammatory stage (facial oedema, necrotic eschar, lymphadenopathy, fever) and two at the stage of sequelae (alopecia and fatigue). Microbiological evidence was present in only one case., Discussion: TIBOLA is a form of rickettsiosis that is currently spreading in Europe. Clinical diagnosis is often made late because of the mild symptoms and the lack of knowledge among clinicians concerning the condition. Microbiological tests (serology, PCR, culture of eschar or serum samples) are negative in one third of cases. The reference treatment consists of antibiotics effective against intracellular bacteria, cyclines and macrolides., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)

Introduction: Extra-cutaneous manifestations of neutrophilic dermatosis are rare. Symptomatic cases are usually multiform and confusing. We report a case with an aseptic lymph node abscess associated with pyoderma gangrenosum., Case Report: A 28-year-old woman with past history of pyoderma gangrenosum was seen for abdominal symptoms and fever related to an epigastric mass. Due to signs indicating abscess formation, surgery was performed and led to total regression of the symptomatology. Recurrence was evidenced 3 months later with skin lesions which were negative on bacteriological examinations. The diagnosis of lymph node manifestations of pyoderma gangrenosum was retained. General corticotherapy was very effective. Relapse occurred again 6 years later and was treated with thalidomide., Discussion: Lymph node involvement has been described in Sneddon-Wilkinson's disease associated with pyoderma gangrenosum. In neutrophilic dermatosis, pulmonary manifestations appear to be the least exceptional of the extra-cutaneous lesions. The pathophysiology has not been elucidated although recent hypotheses suggest that G-CSF could be involved. Corticotherapy is remarkably effective in most cases but thalidomide could be an interesting alternative treatment.

Florid necrotizing lymphadenitis, characterized by segmental infarction and lymphoid hyperplasia, is an uncommon feature of systemic lupus erythematosus (SLE). Kikuchi's disease is a well-defined clinicopathological entity, with a strong preference for the cervical lymph nodes of young women. The etiology of histiocytic necrotizing lymphadenitis (HNL) remains unknown, although viral agents have been proposed. HNL may reflect a self-limited SLE-like autoimmune disease but full-blown SLE associated with this condition has not, to the best of our knowledge, been reported. Thus, ours is the first description of the coexistence of SLE and HNL in 3 patients with immunologically proven parvovirus B19 infections. SLE and HNL were diagnosed simultaneously in 2 patients, but was retrospective in the third, in whom anti-tuberculous therapy was ineffective. Patients 1 and 2 were treated with prednisone (1 mg/kg/d) and responded rapidly. These data suggest that both HNL and SLE flares can be caused by parvovirus B19 infection.

We report a case of a 68 years old male patient treated for chronic lymphocytic leukaemia, presenting a right inguino-crural tender lymphadenopathy with periadenitis. The histologic changes associated with adenitis were large foci of necrosis with regular crown of epithelioid cells, without giant cell. The presence of Herpes simplex virus 2 was confirmed by immunohistochemistry and culture. Occurrence, physiopathology, clinical and histological aspects of Herpes simplex lymphadenitis in patients with haematologic disorders, are discussed.

Three cases of AIDS patients hospitalized for Pneumocystis carinii (PNC.C) pneumonia are reported. These cases are of interest because of the unusual radiological semiology of these pneumocytoses, i.e., their partially or totally pitted nodules. In addition, 4 related facts merit attention: the occurrence of pneumocytosis in 1 patient under prophylactic aerosol pentamidine therapy: the rarity, unusual in AIDS, of PNC.C in the bronchoalveolar lavage fluid from 2 patients; the association of pitted nodules with mediastinal adenopathies due to PNC.C in 1 patient; and the favorable outcome in all cases.

A new route of administration for BCG aimed at stimulating immunity in cancer patients is presented. 40 patients received an intra-lymphatic infusion of BCG and in 20 lymphnode dissection was carried out for bacteriological and histological study. Details of technique and the results are given with regard to the effects of BCG on pelvic and pre-vertebral nodes after injection via a foot vessel.