Background : Tuberculosis is still an important world health problem. The parietal chest wall site in children is a extremely rare form of tuberculosis. Its diagnosis is often so difficult requiring a surgical biopsy. Case presentation : We report the case of 1.5-year-old infant, with no family history of active tuberculosis, who had a swelling of the anterior chest wall for two months. Physical examination found a swelling measuring 1.5 cm by 1 cm in relation to the second parasternal intercostal space, fluctuating in its center, with an inflammatory skin which fistulized giving a bud-like appearance with a purulent exudate. Chest X-ray was normal. The thoracic computed tomography showed a sternal mass responsible for a bone lysis with an infiltration. Pathology examination of biopsies of the parietal mass confirmed the diagnosis of caseo-follicular tuberculosis with lesion of tuberculosis osteitis. Human immunodeficiency virus serology was negative, early morning gastric aspirates performed on two consecutive days were negative for acid-fast bacilli, and quantiferon TB Gold in tube test resulted was also negative. Antitubercular therapy was started with prolonged regimens for 12 months. She has allowed a favorable outcome with healing of the thoracic parietal lesion after 6 months. Conclusions : Diagnosis of chest well tuberculosis is still challenging even if we are in endemic area and it must be conducted early, his management is based on both surgey and antitubercular therapy for having a complete recovery. Prompt diagnosis and treatment are important to prevent serious complications.

Introduction Recent advances in immunologic techniques have lead to increase recognition of primary immunodeficiency diseases (PID). Objective We sought to analyze and describe the spectrum of PID at a tertiary care center in Morocco. Methods A retrospective study from 2011 to 2017 was conducted on 27 children diagnosed with PID. Result Over the study period, combined immunodeficiencies with associated or syndromic features were the most common category (48.15%) followed by immunodeficiencies affecting cellular and humoral immunity (25.9%), congenital defects of phagocyte number or function (14.81%), predominantly anti-body deficiencies (7.4%), and diseases of immune dysregulation (3.7%). The most frequent disorder was Ataxia-telangiectasia (44.4%). The mean age at diagnosis was 4.62 years. The consanguinity rate was 74.1%. The principal clinical signs were lower respiratory tract infections (59.2%), neurological manifes-tations (44.4%), failure to thrive (51.8%) and skin infections (33.3%). Two patients who have immunodeficiencies affecting cellular and humoral immunity died. Conclusion This study indicates that PIDs are not rare in Morocco and that combined immunodeficiencies with associated or syndromic features are the most common category. Future research should focus on identifying gene defect for PID patients.