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Introduction: Rosai-Dorfman disease (RDD) is a rare histiocytic neoplasm. It most commonly presents with bilateral cervical lymphadenopathy. We report the fourth case in the literature of RDD presenting as isolated axillary lymphadenopathy., Case Report: We report the case of a 55-year-old female patient who presented with right axillary lymphadenopathy that had persisted for 1 year, without other associated symptoms. Physical examination revealed an isolated right axillary lymphadenopathy. An excisional biopsy of the lymph node was performed, and histopathological findings were consistent with Rosai-Dorfman's disease. Regular follow-up was recommended., Discussion: RDD is an uncommon histiocytic disorder. Initially identified in the 1960s as a benign, self-limited condition, RDD is now classified as a neoplastic disorder with causative mutations in the MAPK pathway. The classic presentation involves extensive, painless bilateral cervical lymphadenopathy. Isolated axillary lymph node involvement, as seen in our patient, is a rare presentation of nodal RDD with only three cases reported in the literature to date. Histologically, RDD is characterized by a prominent histiocytic infiltrate set against a background of inflammatory cells, primarily composed of lymphocytes and plasma cells. These histiocytes are typically hypochromatic, with abundant pale cytoplasm, and exhibit varying degrees of emperipolesis. In 2018, consensus guidelines for the management and evaluation of RDD were introduced., Conclusion: Recent advances in genetic sequencing have reclassified RDD from a benign inflammatory disorder to a histiocytic neoplasm. Further research is needed to fully understand its implications for prognosis and treatment strategies., Competing Interests: Declaration of competing interest All authors declare no conflicts of interest., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Since 2012, the northeast region of Tunisia has witnessed an increase in dog rabies cases, indicating a concerning emergence of the disease. Previous studies have indicated the widespread nature of rabies in northern Tunisia. However, there remains a lack of comprehensive understanding regarding the associated risk factors., Aim: This study aimed to identify potential risk factors associated with the occurrence of dog rabies in northeast Tunisia through a case-control approach., Methods: A case-control study was conducted, involving a case group ( n = 77) consisting of dogs confirmed positive for rabies at the referral laboratory using the Fluorescent Antibody Test between 2013 and 2019. The control group ( n = 77) comprised both negative cases received at the laboratory and dogs that underwent a 15-day quarantine period and received a certificate of absence of rabies after observation. Univariate and multivariate logistic regression analyses were performed to explore various potential risk factors, including age, sex, breed, confinement, vaccination status, presence of bites, ownership status, origin of dogs, geographic sector, presence of rabies cases, and proximity to slaughterhouses., Results: The final logistic regression model revealed several significant findings. The odds of an unconfined dog being affected by rabies were nearly twice as high as for confined dogs odds ratio [OR = 1.9; 95% confidence intervals (CI): 1.17-3.27]. Furthermore, the odds of rabies occurrence were 25 times higher in areas where rabies cases had been reported within the previous 3 months to 1 year compared to uninfected areas (OR = 25.7; 95% CI: 3.02-219.14). Dogs born at home to the owner's bitch were also found to be at significantly higher risk of rabies (OR = 2.41; 95% CI: 1.14-5.13). Additionally, residing in areas with reported rabies cases in the last 3 months was found to increase the risk of rabies by 2.8 times (OR = 2.8; 95% CI: 1.16-6.77). However, vaccination was associated with a 1.6-fold reduction in the risk of contracting rabies (OR = 0.6; 95% CI: 0.38-0.97)., Conclusion: This study provides valuable insights into the risk factors associated with dog rabies in northeast Tunisia. The findings underscore the importance of implementing targeted control measures, such as increased vaccination coverage and enhanced confinement measures, to mitigate the spread of rabies in the region. These findings can inform decision-making processes aimed at improving the effectiveness of national rabies control programs., Competing Interests: The authors declare that the study was carried out in the absence of any financial relationships that could be interpreted as a potential conflict of interest.