Facial abscess: a case report

This report describes a patient with a migratory abscess as a sequel to the surgical removal of a mandibular third molar tooth. Culture of pus drained from the abscess revealed no growth, probably because of previous management with antibiotics.     

An unusual case of dental infection by Pseudomonas aeruginosa causing a brain abscess: case report

A brain abscess may result when dental infection reaches the brain through contiguous anatomic cavities such as the maxillary sinus, the ethmoid sinus and the orbital cavity. It is an important complication and should be treated aggressively. Such treatment would include the excision of the etiological factor, drainage and adjuvant antibiotic therapy. The present case concerns a 23 year old woman who presented at the General Hospital of Nova Iguaçu with complaints of pain in the right side of the face and was diagnosed with acute sinusitis. Antibiotics and analgesics were prescribed to treat the disease. However, after 10 days, she returned to the emergency room, presenting with proptosis of the right eyeball, subconjunctival haemorrhage, ophthalmoplegia and intense pain in the right orbit, in addition to headaches. After computed tomography was performed, she was diagnosed with a brain abscess in the frontal lobe with the involvement of the maxillary right first molar, the maxillary sinus, the ethmoid sinus and the orbital cavity. With culturing of the secretion, the growth of Pseudomonas aeruginosa colonies was evident. Treatment consisted of a craniotomy to drain the brain abscess, a Caldwell–Luc procedure to drain the right maxillary sinus, dental extraction and aggressive antibiotic therapy. After 6 weeks, the patient was discharged with no neurological sequelae.     

Wegener's granulomatosis presenting as oral lesions: A case report

Wegener's granulomatosis will classically present as a triad of respiratory, kidney, and vascular involvement. The disease may run a course of rapidly progressive or mild and indolent and escape diagnosis for some time. The clinician must be aware of the possibility of Wegener's granulomatosis presenting initially with intraoral lesions. Prompt biopsies and blood studies along with the proper referrals will give the patient their best chance at a remission with the least systemic damage. We present a case of Wegener's granulomatosis that presented with oral lesions before other signs and symptoms.     

Leiomyosarcoma presenting as a mandibular gingival swelling: a case report

We report a case of primary low-grade leiomyosarcoma of the mandible in an otherwise healthy young woman. The neoplasm presented as a painful, pericoronal gingival swelling that mimicked an acute periodontal infection. It was managed accordingly, with curettage, debridement, and antibiotics. When the lesion failed to respond to this treatment approach, a biopsy was performed. Microscopy revealed a malignant mesenchymal neoplasm which, on immunohistochemistry analysis, demonstrated reactivity for smooth muscle actin (SMA) and vimentin. This established the diagnosis of leiomyosarcoma; subsequently, an en bloc resection of mandibular bone and overlying soft tissue was performed. Close follow-up for over 10 years has revealed no evidence of recurrent or metastatic disease. Since the patient was taking oral contraceptives prior to the onset of the lesion, a possible link between estrogen and smooth muscle tumors is considered.     

Pemphigus vulgaris presenting as a gingival lesion. A case report

A 26-year-old hispanic male presented with a nonspecific gingival lesion initially presumed to be of infectious etiology. During continued follow-up over several weeks, the lesion evolved into one typical of desquamative gingivitis. Direct immunofluorescent testing and routine histopathology resulted in a diagnosis of pemphigus vulgaris, which was confirmed by indirect immunofluorescence. Although it is unusual for pemphigus vulgaris to present with the gingiva as the sole primary site of involvement, this case serves to enhance our awareness of the gingiva as a site at which systemic disease can be manifested.     

Leprosy presenting as orofacial pain: case report

This article reports an unusual case of neuropathic orofacial pain secondary to leprosy. To the authors' knowledge, it is the first case of leprosy reported in the Western literature that was initially thought to be dental pain, then mistaken as a temporomandibular disorder before the correct diagnosis was made. The patient had migrated to Australia from India 24 years previously and was otherwise healthy without any overt features suggestive of infection. A review of the literature revealed that the trigeminal nerve is frequently involved in leprosy, usually associated with sensory loss rather than neuropathic pain. Even in Western countries, patients originally from countries where leprosy is endemic may develop symptoms of the disease many years later. The possibility of leprosy should be considered in the diagnosis of neuropathic orofacial pain in such patients.     

Multiple brain abscess from dental origin: case report and literature review

Background

Brain abscess of dental origin is a rare situation and deserves attention due to its high mortality rate even when adequate treatment is done. Few reports are available when dental origin is the main cause of this infection.

Case report

We present the case of a 70-year-old man diagnosed with cerebral abscess caused by apical lesions located at superior and inferior teeth. The three lesions containing pus were drained from anterior and posterior brain region and the laboratory evaluation revealed the presence of Streptococcus viridians and Bacteroides. Postoperative period was uneventful with excellent recovery after 1?year of surgery. Final diagnosis was able to be done due to excellent image exams availability like computer tomography and magnetic resonance using diffusion and perfusion techniques.

Discussion

The early detection of this pathology with the correct diagnosis essential to give the patient the best treatment including antimicrobial drugs and drainage is of extreme importance.     

Primary tuberculosis clinically presenting as gingival enlargement: a case report

Tuberculosis is a chronic systemic granulomatous disease which rarely affects the oral cavity. Oral lesions can be either primary or secondary to systemic tuberculosis, the former being rare. This is a never-before reported case of primary tuberculosis presenting as a localized diffuse gingival enlargement in an 11-year-old Indian female patient. The diagnosis was reached through identification of positive histopathological features, Tuberculin test results, presence of anti-tubercular antibodies confirmed by a polymerase chain reaction. In view of the recent increase in the incidence of tuberculosis and the prevalence of the same, it is reasonable to include tuberculosis in the differential diagnosis of gingival enlargements. This is essential to avoid any serious complications for both the clinician and patient due to a delay in the diagnosis of such a rare but plausible oral condition.     

Multiple myeloma presenting as a painful mandibular swelling: a case report

Multiple myeloma is a disease characterized by monoclonal proliferation of plasma cells, the most differentiated stage of B-cells. Primary manifestation of multiple myeloma in the jawbones is rare. In the case reported here, a 29-year-old woman who presented with a right mandibular swelling after extraction of a mobile painful tooth turned out to have multiple myeloma. Current diagnostic criteria and management strategies of the disease are discussed.     

Metastatic cancer presenting as TMD. A case report

The dentist's responsibility in managing patients should include the awareness that not every pain in the face is due to a toothache or a temporomandibular disorder (TMD). This paper reviews the case of a 66-year-old patient who presented to the dental office with a chief complaint of unilateral jaw pain. The symptoms seemed consistent with TMD. Two years prior, the patient had undergone successful removal of a cancerous prostate and had remained under urologist care with a favorable prognosis. Subsequent imaging studies confirmed that the facial pain was due to multiple metastatic lesions to areas including the zygoma, infratemporal fossa, maxilla and brain. However, these metastatic lesions were not of prostate origin, but rather were from a squamous cell carcinoma originating in a primary site other than the prostate.     

右上颌窦囊肿误诊为根尖周脓肿1例

上颌窦囊肿为上颌窦常见疾病,虽然生长缓慢,但发展到一定程度后也会出现临床症状。现报道右上颌窦囊肿被误诊为根尖周脓肿1例,并分析其X线片表现和诊断要点。     

Juvenile nasopharyngeal angiofibroma presenting as a facial swelling. A case report

Juvenile nasopharyngeal angiofibroma is a rare benign neoplasm occurring almost exclusively in adolescent males. When it is confined to the nasopharynx, surgery is often curative. In 20% of cases, there is intracranial extension, and radiotherapy may be used to avoid the risk of life-threatening haemorrhage. The authors report an unusual case which presented with a swelling of the cheek and an abducens nerve palsy. The lesion extended from the nasopharynx across the pterygomaxillary fissure, as well as intracranially. Radiotherapy was given, and the patient remains disease-free after one year.