IntroductionTuberculosis is a chronic granulomatous infection caused by Mycobacterium tuberculosis (MTB). It is a common disease in low- and middle-income countries of the world. Tuberculosis (TB) primarily affects the lungs but can also affect other organs (extra-pulmonary) such as the lymph nodes, genitourinary system, bones and joints, gastrointestinal system, central nervous system, and spine.Breast tuberculosis (BTB) was first described by Sir Astley Cooper in 1829 [1, 2]. It’s characterized by granulomatous inflammation of the breast parenchyma, which may present with cutaneous manifestations including skin changes and ulceration. The breast is a rare site of manifestation of extra-pulmonary tuberculosis, especially as a primary manifestation, even in tuberculosis-endemic countries [3-6]. It generally affects women of reproductive age, commonly between 21 and 30 years old [3, 4, 6, 8, 10].The incidence of BTB is estimated to account for 0.1% of breast diseases in developed countries but reaches 3% to 4.5% in endemic countries [3, 6, 7, 9, 10]. The factors thought to be responsible for the higher incidence of the disease in the developing world include HIV/AIDS, an increase in the prevalence of multi-drug-resistant tuberculosis, and the increasing age of lactating women [5, 11].The clinical presentation of BTB is often insidious and non-specific, mimicking the signs of breast carcinoma. It can present as a breast abscess, a unilateral painless mass, or a sinus and it may sometimes mimic breast cancer [10]. Clinically and radiologically, BTB can resemble a pyogenic breast abscess, fibroadenoma, or carcinoma. The most concerning differential diagnosis is carcinoma of the breast because of the inherent consequences of the treatment, including chemotherapy. The role of microbiology tests in the diagnosis of BTB is, therefore, paramount. Histologic confirmation requires demonstration of acid and alcohol fast bacilli (AAFB), GeneXpert, culture, or polymerase chain reaction (PCR) as means of identifying the causative mycobacterial organism.This report illustrates a case of GeneXpert-confirmed BTB encountered in a tertiary hospital in Ethiopia and highlights the salient features that may aid in diagnosis.

Herpes simplex encephalitis complicated with vasculitis in a young Male: A case reportDr. Sebhatleab T.1, Dr.Abel T. 1Dr.Estifanos B2,Dr.Zablon M 3, Dr.Merchaye A.3, Dr. Raja T.41. Department of Internal Medicine, School of Health Sciences, Addis Ababa University, Addis Ababa.2.Department of Neurology, School of Health Sciences, Addis Ababa University, Addis Ababa3.Bethzatha General Hospital, Addis Ababa, Ethiopia4.Department of Radiology, School of Health Sciences, Addis Ababa University, Addis Ababa

A document by Gebeyehu Azibte. Click on the document to view its contents.

Introduction Nearly 25% of systemic symptoms of autoimmune disorders are misdiagnosed and mismanaged and often come with flare-ups or complications. The coexistence of multiple rheumatic diseases makes it more challenging regarding both management and diagnosis. Several types of overlap syndrome are documented in the literature. While two or more rheumatic diseases coexist, one disease often is clinically predominant. Rhupus syndrome, which combines the clinical and laboratory aspects of rheumatic arthritis (RA) and systemic lupus erythematosus (SLE), is one of the uncommon and sporadically documented overlaps. SLE and RA are systemic autoimmune rheumatic illnesses that affect multiple organs and systems and have unique clinical and serological traits.  (1)“ Rhupus” was first coined in 1971 to describe patients who satisfy the criteria for both systemic lupus erythematosus(SLE) and rheumatoid arthritis(RA). (2) it has been defined as a deforming and symmetric polyarthritis accompanied by symptoms of SLE and the presence of antibodies such as ant-ds-DNA, anti-smith, and rheumatoid factor with or without ant-CCP antibody. (a)  because of the rarity of the disease the prevalence, pathophysiology, natural history, and radiological and immunological profiles profile of rhupus are poorly described.There is no known etiology causing the disease but there are limited studies suggesting the combined role of genetic, immunological, hormonal, and environmental factors in the progression of the disease. (3) identification of rhupus is very essential owing that their therapy and outcome differ from those patients having RA or SLE alone. (4)We report one such rare case below.Case presentation :