Facial Candidal Abscess in a Patient with Unknown Type 2 Diabetes Mellitus

Introduction

Facial candidal abscess is an infection with a fungal cause which was presented in this case such a rarity. We report a rare case of facial abscess due to Candida species in a patient with unknown diabetes.

Materials and Methods

The patient presented with a longstanding firm swelling which occurred 2 weeks ago and did not show any improvement of healing process in spite of surgical and medical treatments. MRI examinations were conclusive and compatible with abscess, so she underwent surgical intervention. Facial candidal abscess was the final diagnosis.

Conclusions

We concluded that, in persistent abscesses, invasive candidiasis should be considered in the differential diagnosis of bacterial infections as it generally affects individuals with diabetes or general defects in the immune system, or those who use widespread antibiotics and steroids.     

Brain abscess by mycotic and bacterial infection in a diabetic patient: clinical report and review of literature

This report presents a case of lethal invasive mucormycosis, a rare fungal infection, which predominantly affects immunocompromised patients, and is reported in a 57-year-old female who presented with cerebral abscess. The patient, who had undiagnosed diabetes mellitus, presented with extensive right hemifacial deficiency of the bones and soft tissues consequent to surgical resection of the ethmoid-spheno-maxillo-orbital district after mucormycosis. A reconstruction with a pectoral pedunculated flap was performed. The maxillary swelling extended to the contiguous area, involving the palate and homolateral orbital floor. Mucous and cutaneous samples showed the presence of Aspergillus fumigatus, and diagnosis of rhinocerebral mucormycosis was made. The patients also presented with a right hemiplegia consequent to a cerebral abscess by Eikenella corrodens. The authors decided to position an intraoral prosthesis to restore palatal integrity and masticatory function and inserted four titanium fixtures for the retention of the bone-anchored facial prosthesis.     

Treatment of peri-implant recession with a screw-retained,interim implant restoration: A clinical report

This clinical report describes a patient with an osseointegrated implant and definitive restoration of the maxillary right lateral incisor who was seeking resolution of the recession of the peri-implant tissues which revealed the underlying zirconia abutment. The patient had previously received a connective tissue graft in an unsuccessful attempt to resolve the recession. An undercontoured interim restoration that allowed for soft tissue coronal migration resolved the soft tissue deficiency.     

Submandibular abscess caused by Salmonella

Salmonella species represent uncommon causative agents in focal infections of the head and neck. This article presents a rare case of Salmonella submandibular abscess in a 59-year-old patient with diabetes mellitus, chronic hepatitis and liver cirrhosis. The patient was successfully treated with drainage of the abscess and oral administration of quinolone. An immunocompromised condition can be a critical predisposing factor for Salmonella submandibular abscess.     

Marginal zone B-cell lymphoma of minor salivary gland representing tumor-forming amyloidosis of the oral cavity. A case report

We report here a case of mucosa-associated lymphoid tissue (MALT)-type lymphoma arising from the minor salivary gland of the oral cavity exhibiting tumor-forming amyloidosis. The patient was a 64-year-old Japanese woman who presented with 4-year history of a left soft palate mass. Despite multiple and multifocal recurrences including the lip, soft palate, tongue, oral base and vocal code and soft palate, the tumor remained localized in the upper aerodigestive tract, and the patient did not develop multiple myeloma during the course of disease. Histologically, the majority of the lesion was occupied by amyloid deposition. Only the periphery of the lesion contained numerous plasmacytoid cells, along with occasional centrocyte-like cells. In addition, lymphoepithelial lesion and follicular colonization were noted. The present case indicates that primary minor salivary gland MALT-type lymphoma appears to be the cause of tumor-forming amyloidosis of the upper aerodigestive tract including the larynx.     

Invasive rhinomaxillary mucormycosis: a case report with a review of the literature

Mucormycosis is a rare, often fatal disease that is caused by zygomycetes, which are common fungi frequently found in the soil and decaying vegetation. Diabetes mellitus, malnutrition, and an immunocompromised state favor the growth of various microorganisms, including zygomycetes and the normal flora of the oral cavity, which are otherwise nonpathogenic, leading to opportunistic infections. Here we report a case of mucormycosis presenting with extensive necrosis of the maxilla along with rhinocerebral involvement in a 60-year-old patient suffering from uncontrolled diabetes with ketoacidosis.     

Necrotizing soft tissue infections of the head and neck: case reports and literature review

A small but nevertheless important part of a surgeon's experience comprises necrotizing soft tissue infections of the head and neck. The purpose of this report is to heighten awareness of necrotizing soft tissue infections in any patient with an infection of the head and neck. The article also outlines an appropriate management strategy for use in the treatment of patients with this potentially fatal condition. Prompt diagnosis and early radical surgical debridement are significant factors in avoiding a fatal outcome in these patients. This article reviews the literature on necrotizing soft tissue infections of the head and neck and presents cases from our recent experience.     

Subcutaneous temporal abscess as a clinical manifestation of pulmonary arteriovenous malformations in a patient with hereditary haemorrhagic telangiectasia (Rendu-Osler-Weber disease)

This is the report of a rare case of a temporal abscess that developed in the presence of pulmonary arteriovenous malformations in a patient with hereditary haemorrhagic telangiectasia (HHT). Little has been described about abscesses occurring in soft tissues in patients with HHT in previous reports. In the case of a subcutaneous abscess of unknown primary in the head and neck region in patients with HHT, the clinician needs to consider septic microemboli due to pulmonary arteriovenous malformations as a possible cause. The classic dermal manifestation of HHT should be enlarged to include subcutaneous abscess secondary to metastatic septic microembolism.     

Treatment of an Acute Apical Abscess in a Patient With Autoimmune Hepatitis Taking Alendronate: A Case Report

IntroductionThe aim of this study was to report a patient's clinical case who was diagnosed with severe apical abscess and with autoimmune hepatitis (AIH) using immunosuppressive drugs and bisphosphonate.MethodsA 32-year-old man of black African descent urgently sought dental surgery because of an increase in volume in the right genic region and a nuisance in the region of the lower right second premolar when chewing. After intraoral and radiographic clinical examination, the patient was diagnosed with pulp necrosis and an acute apical abscess. Because he had AIH and was taking corticosteroids and bisphosphonate (alendronate), he was submitted to endodontic therapy as a minimally invasive treatment, considering his systemic state.ResultsAfter 3 years of follow-up treatment with periapical and tomographic radiographic control, bone repair of the periapical region of the tooth was observed.ConclusionsThrough this report, we can infer that it is possible to reverse the condition of a periapical lesion in a tooth with an acute apical abscess and necrotic pulp in an AIH patient who is using alendronate without the need for more invasive procedures and that would put at risk the patient's general and oral condition in the postoperative period.     

111例下行性坏死性纵隔炎的诊断与治疗

目的: 探讨下行性坏死性纵隔炎的临床特点、早期诊断和治疗方法,以降低该病的死亡率。方法: 回顾分析2013年1月—2016年10月于上海交通大学医学院附属第九人民医院诊治的下行性坏死性纵隔炎病例,总结其性别、年龄、合并症、感染源、影像学检查结果、细菌学检查结果、治疗手段和治疗结果。结果: 共收集111例患者,平均年龄56.6±12.5岁,男女比为5.9∶1。主要感染源为牙源性感染,其次为腺源性感染。52例（46.8%）患者有合并症,其中以Ⅱ型糖尿病最常见。所有患者均行颈胸部CT检查。主要致病菌为链球菌。所有患者均行全身抗感染治疗和颈部切开排脓,106例患者经颈部切口行上纵隔引流,9例行开胸手术清创引流。死亡率为6.3%。结论: 胸部CT检查是早期诊断下行性坏死性纵隔炎的有效手段。早期诊断、有效的抗菌治疗、充分的切口引流及全身支持治疗是降低死亡率的主要措施。     

Osteomyelitis of the mandible associated with autosomal dominant osteopetrosis: a case report

Osteopetrosis is a rare hereditary bone disorder presenting with variable clinical features and is characterized by an increase in bone density. The main clinical findings of the benign-type of osteopetrosis (autosomal dominant) are fractures and osteomyelitis of the mandible, leading to the detection of the disease. We report a case of autosomal dominant osteopetrosis with secondary mandibular osteomyelitis. Clinical and radiological patterns and treatment evaluation were assessed. The patient was referred for evaluation and treatment of an acute abscess in the left side of the face and osteomyelitis of the mandible. Several imaging studies were performed to assess the lesion and the adjacent bone and soft tissue structures. Treatment consisted of intravenous antibiotic therapy, debridement of the necrotic bone and sequestrum, and extra-oral drainage of the abscess, with submandibular access. Healing was uneventful.     

Odontogenic orbital abscess: a case report and review of literature

Odontogenic orbital abscess is a rare but well-documented complication of sinusitis and infections spreading from dental apical lesion. We report a case of orbital abscess with periorbital cellulitis, in a 35-year-old man with positive recent dental history of a periapical dental infection arising from the second upper left premolar spread into maxillary sinus. The patient has shown facial edema, ocular pain, ophthalmoplegia, proptosis, and initial visual symptoms. A surgical intervention to drain the abscess and a revision of the dental lesion and maxillary sinus were required. A review of literature is also reported focusing on etiology and treatment options dealing with odontogenic orbital abscess and cellulitis.     

Brain abscess from chronic odontogenic cause: report of case

A case of a chronic odontogenic abscess that probably precipitated a frontopatrietal brain abscess by hematogenous spread has been presented. A thorough examination of the patient showed no other source of infection. Peptostreptococcus sp was found as the common pathogen despite 6 days of broad-spectrum antibiotic therapy. This case emphasizes the important role of dentistry in medical diagnosis and treatment implemented in the hospital setting.     

口腔颌面、颈深部及纵隔感染的诊断与处理:附6例分析

目的：探讨口腔颌面部感染引发颈深部及纵隔感染的临床表现、治疗和转归。方法：回顾分析1998～2005年在我科就诊的6例患者，分析其感染来源、相关全身疾病、细菌培养结果、并发症及治疗结果。结果：6例患者中，男4例，女2例，年龄30～82岁，平均年龄47岁。感染来源分别为牙源性感染4例（下颌第三磨牙冠周炎），上呼吸道感染1例，1例原因不明，2例伴有糖尿病。临床主要表现为双侧下颌下、颈部广泛肿胀，脓肿形成，同时伴有胸前区充血、肿胀及脓液渗出。X线及CT检查显示，4例纵隔及胸腔内有脓肿形成。细菌培养结果以杆菌为主。经广泛局部切开引流、胸腔引流及抗生素治疗后，4例痊愈，2例死亡（死亡率33．3％）。结论：口腔颌面、颈深部及纵隔感染死亡率较高：胸部增强CT扫描对早期诊断有很高的价值：一旦确诊，应及早行多部位切开引流和胸腔引流；细菌培养对抗生素应用具有重要指导意义，而支持治疗和多学科协助治疗是成功抢救的关键。     

Torulopsis glabrata infection in the oral cavity

The first case report of an oral infection due to Torulopsis glabrata is presented. This microorganism is a yeast-like fungus grouped in a similar family to the Candida species. It has been isolated with increasing frequency from the oral cavity but, surprisingly, has not been reported as a pathogen in this site. In other anatomical sites, including the urinary tract, lung and gastrointestinal tract, Torulopsis glabrata has been reported as a pathogen, at times resulting in a fatal outcome. However, there has usually been some modifying factor, e. g. malignancy, cytotoxic drug therapy, diabetes or broad spectrum antibiotics, which caused this marginal pathogen to assume a pathogenic role. No such modifying factors could be elicited in this case. The history of the case including the management is presented. A brief outline of the microbiologic grouping of Torulopsis glabrata is given, as well as the diagnostic test used in its identification. The histopathology is described and the necessity for combining special tests in establishing a positive diagnosis is exemplified, as the histology alone is not pathognomonic of the infection.     

Lethal invasive mucormycosis: case report and recommendations for treatment

A case of lethal invasive mucormycosis (IM), a rare fungal infection which predominantly affects immunocompromised patients, is reported in a 73-year-old female patient who presented with a cervical abscess. The patient had asthma treated with steroids and had previously undiagnosed diabetes mellitus. Despite surgical treatment and parenteral antibiotic therapy, there was fatal progression of the condition. The pathogenesis, histological appearances and treatment of mucormycosis are discussed, particularly the importance of urgent histological examination of debrided tissue to distinguish this condition from necrotizing fasciitis (NF) earlier than microbiological culture alone would allow, thus permitting the early introduction of appropriate antifungal therapy.     

Retrieval and reattachment of an elusive tooth fragment

Traumatic dental injuries of uncomplicated nature are a common finding and upper central incisors are the most commonly affected teeth. Sometimes, the fractured fragment or the tooth gets embedded in the surrounding soft tissues and is often missed. There are few case reports regarding the retrieval and reattachment of tooth fragment. This report presents the case of an 8-year-old girl who came with the chief complaint of pain, irritation, and tingling sensation in the lower lip since one year when her upper central incisors got fractured due to trauma along with lip laceration. A soft tissue radiograph of lower lip revealed the presence of fractured tooth fragment which was then surgically removed and reattached to one of the fractured incisors. The patient was found to be asymptomatic after the procedure. This report further highlights the importance of proper radiographic diagnosis along with clinical examination immediately after trauma in order to prevent any complications in future.     

Facial necrotising fasciitis following rhytidectomy

Rhytidectomy is the most common surgical procedure used to rejuvenate the appearance of the aging face and neck. Necrotising fasciitis is a rapidly progressing, life-threatening, bacterial infection of the skin, the subcutaneous tissue, and the fascia. We report a case of necrotising fasciitis of the face caused by a group A streptococcal infection after rhytidectomy on a healthy female patient. An abscess on her hand that had been caused by an infection related to a venous catheter had provided a potential entry for the pathogen, and treatment combined both surgical debridement and antibiotics. The operation had resulted in large tissue losses around the ears, which we treated by healing by second intention.     

An adult case of oral infection with Kingella kingae

An exceptional case of microbiologically confirmed oral infection with Kingella kingae in an immunocompetent adult (30-year-old woman) is presented and the pathogenesis is discussed and related to known literature data.K. kingae is a rather common but yet relatively unknown commensal corroding bacterium from the oro- and nasopharynx in healthy children, which might turn into a human pathogen causing osteomyelitis, arthritis, spondylitis, endocarditis and intervertebral diskitis in young children and rarely endocarditis, septic arthritis, meningitis, epiglottitis, diskitis and bacteraemia in adults. Sofar K. kingae associated stomatitis was reported in children and a few adults, however, with concomitant herpes simplex virus infections, and without microbiological confirmation. In the described case no viral infection was found. The proven K. kingae stomatitis represents an extension of the pathogenic spectrum and suggests that the breach of the oral mucosal barrier can be caused by the bacterial pathogen itself. Whether a concomitant viral infection is necessary forK. kingae to actually invade the bloodstream remains to be considered.