scholarly journals Mucormycosis of the hard palate masquerading as carcinoma

2012 ◽  
Vol 2 (1) ◽  
pp. 28 ◽  
Author(s):  
Bhari Sharanesha Manjunatha ◽  
Nagarajappa Das ◽  
Rakesh V. Sutariya ◽  
Tanveer Ahmed
Keyword(s):  
Clinical Presentation ◽  
Fungal Infections ◽  
Survival Rates ◽  
Positive Culture ◽  
Staining Technique ◽  
Necrotic Bone ◽  
Chronic Ulcers ◽  
Hematoxylin And Eosin ◽  
Clinical Differential Diagnosis ◽  
Hematoxylin And Eosin Stain

A growing number of medically compromised patients are encountered by dentists in their practices. Opportunistic fungal infections such as mucormycosis usually occur in immunocompromised patients but can infect healthy individuals as well. Mucormycosis is an acute opportunistic, uncommon, frequently fatal fungal infection, caused by a saprophytic fungus that belongs to the class of phycomycetes. Among the clinical differential diagnosis we can consider squamous cell carcinoma. Such cases present as chronic ulcers with raised margins causing exposure of underlying bone. There is a close histopathological resemblance between mucormycosis and aspergillosis. Microscopically, aspergillosis has septate branching hyphae, which can be distinguished from mucormycotic hyphae by a smaller width and prominent acute angulations of branching hyphae. A definitive diagnosis of mucormycosis can be made by tissue biopsy that identifies the characteristic hyphae, by positive culture or both. The culture of diseased tissue may be negative and histopathologic examination is essential for early diagnosis. Mucormycosis was long regarded as a fatal infection with poor prognosis. However with early medical and surgical management survival rates are now thought to exceed 80%. In the present case, the fungus was identified by hematoxylin and eosin stain and confirmed by Grocott’s silver methenamine special staining technique. Removal of the necrotic bone, which acted as a nidus of infection, was done. Post-operatively patient was advised an obturator to prevent oronasal regurgitation. Since mucormycosis occurs infrequently, it may pose a diagnostic and therapeutic dilemma for those who are not familiar with its clinical presentation.

scholarly journals Primary Nasal Tuberculosis: Resurgence or Coincidence − A Report of Four Cases with Review of Literature

2017 ◽  
Vol 9 (01) ◽  
pp. 026-030 ◽  
Author(s):  
Sabina Khan ◽  
Mukta Pujani ◽  
Sujata Jetley
Keyword(s):  
Clinical Presentation ◽  
Tertiary Care ◽  
Histopathological Diagnosis ◽  
Care Hospital ◽  
Female Ratio ◽  
Antituberculous Treatment ◽  
Hematoxylin And Eosin ◽  
Hematoxylin And Eosin Stain ◽  
Male To Female

ABSTRACT Background: Primary nasal tuberculosis (TB) is a rare form of TB even in areas with high TB incidence. It is timely diagnosis and proper management are often delayed due to its rarity and nonspecific clinical presentation. Aim: The aim of the study was to review histopathologically diagnosed cases of nasal TB over a period of 1 year and to describe its clinical presentation, diagnostic workup, the importance of histopathological diagnosis along with a brief review of the literature. Materials and Methods: This was a retrospective study done in the Department of Pathology of a Tertiary Care Hospital of Delhi over a period of 1 year where all the cases with histopathological diagnosis of nasal TB were reviewed. Patients’ clinical details, investigations and treatment details along with follow‑up were obtained from the medical records section. For each case, routine hematoxylin and eosin stain were studied along with Ziehl–Neelson staining. Results: A total of four patients were diagnosed with nasal TB histopathologically. Patients’ age ranged from 5 to 34 with an equal male to female ratio. All patients were immunocompetent. Primary nasal TB was seen in all of the four cases. None of the cases, it was clinically suspected, and histopathology was the mainstay of diagnosis. All the cases were treated with antituberculous treatment and showed considerable improvement. Conclusions: Although nasal TB is rare, it should be considered in the differential diagnosis of chronic nasal symptoms and granulomatous lesions of the nose. Histopathology plays an important role in the diagnosis of these clinically unsuspecting cases of nasal TB.

Not just vegetations: focal myocardial changes in patients with fungal infections

2020 ◽  
pp. 1-6
Author(s):  
Nicole M. Cresalia ◽  
Sonal T. Owens ◽  
Terri L. Stillwell ◽  
Mark D. Norris ◽  
Sunkyung Yu ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Bacterial Infections ◽  
Fungal Infections ◽  
Positive Culture ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Similar Proportion ◽  
Retrospective Case ◽  
Fungal Endocarditis ◽  
Catheter Tip

Abstract Background: Fungal endocarditis classically involves dense heterogenous vegetations. However, several patients with fungal infections were noted to have myocardial changes ranging from focal brightening to nodular thickening of chordae or papillary muscles. This study evaluates whether these findings are associated with fungal infections. Methods: In a retrospective case–control study, paediatric inpatients with fungal infections (positive blood, urine, or catheter tip culture) in a 5-year period were matched 1:1 to inpatients without positive fungal cultures. Echocardiograms were scored on a 5-point scale by two independent readers for presence of myocardial brightenings, nodular thickenings, and vegetations. Clinical data were compared. Results: Of 67 fungal cases, positive culture sites included blood (n = 44), vascular catheter tip (n = 7), and urine (n = 29); several had multiple positive sites. “Positive” echo findings (score ≥ 2+) were more frequent in the Fungal Group (33 versus 18%, p = 0.04). Fungal Group patients with “positive” versus “negative” echo findings had similar proportion of bacterial infections. Among fungal cases, those with “positive” echo findings had longer hospital length of stay than cases with “negative” echos (median 58 versus 40 days, p = 0.03) but no difference in intensive care unit admission, extracorporeal membranous oxygenation support, or mortality. Conclusions: Myocardial and papillary muscle brightening with nodular thickening on echocardiogram appear to be associated with fungal infections. There may be prognostic implications of these findings as patients with “positive” echo have longer length of stay. Further studies are needed to better understand the mechanism and temporal progression of these changes and determine the prognostic value of this scoring system.

Histologic Evaluation of Osseous Regeneration Following Combination Therapy With Platelet-Rich Plasma and Bio-Oss in a Rat Calvarial Critical-Size Defect Model

2015 ◽  
Vol 41 (5) ◽  
pp. 543-549 ◽  
Author(s):  
Philip J. DeNicolo ◽  
M. Kelly Guyton ◽  
Michael F. Cuenin ◽  
Steven D. Hokett ◽  
Mohamed Sharawy ◽  
...  
Keyword(s):  
Bone Regeneration ◽  
Bone Growth ◽  
Critical Size ◽  
Close Contact ◽  
Platelet Rich Plasma ◽  
Critical Size Defect ◽  
Histologic Evaluation ◽  
Hematoxylin And Eosin ◽  
Hematoxylin And Eosin Stain ◽  
Osseous Regeneration

Platelet-rich plasma (PRP) is an autogenous source of growth factors shown to facilitate human bone growth. Bio-Oss, an osteoconductive xenograft, is used clinically to regenerate periodontal defects, restore dental alveolar ridges, and facilitate sinus-lift procedures. The purpose of this study was to analyze whether a combination of PRP and Bio-Oss would enhance bone regeneration better than either material alone. PRP and/or Bio-Oss were administered in an 8-mm critical-size defect (CSD) rat calvarial model of bone defect between 2 polytetrafluoroethylene membranes to prevent soft tissue incursion. Eight weeks after the induction of the CSD, histologic sections were stained with hematoxylin and eosin stain and analyzed via light microscopy. Qualitative analyses revealed new bone regeneration in all 4 groups. The Bio-Oss and PRP plus Bio-Oss groups demonstrated greater areas of closure in the defects than the control or PRP-only groups because of the space-maintaining ability of Bio-Oss. The groups grafted with Bio-Oss showed close contact with new bone growth throughout the defects, suggesting a stronger graft. The use of PRP alone or in combination with Bio-Oss, however, did not appear to enhance osseous regeneration at 8 weeks. Areas grafted with Bio-Oss demonstrated greater space-maintaining capacity than controls, and PRP was an effective vehicle for placement of the Bio-Oss. However, at 8 weeks this study was unable to demonstrate a significant advantage of using PRP plus Bio-Oss over using Bio-Oss alone.

scholarly journals Unusual Site for a White Nodule on the Palatine Tonsil: Presentation, Differential Diagnosis, and Discussion

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Ashwag Yagoub Aloyouny
Keyword(s):  
Differential Diagnosis ◽  
Clinical Presentation ◽  
Surgical Intervention ◽  
Fungal Infections ◽  
The Body ◽  
Palatine Tonsil ◽  
Unusual Site ◽  
Case Presentation ◽  
Lymphoepithelial Cysts ◽  
Malignant Lesions

Introduction. Palatine tonsils are part of the mucosa-associated lymphoid tissue, located in the oropharyngeal region. Although these tissues protect the body from foreign intruders, they are more prone to infections due to their anatomical structure and location. For instance, the differential diagnosis of a white lesion on the palatine tonsil can range from benign to malignant lesions. Oral lymphoepithelial cysts commonly arise as painless, yellowish nodules on the floor of the mouth and the ventral or lateral surface of the tongue. Case Presentation. This paper presents a rare case of an unusual site of a lymphoepithelial cyst (LEC) in the oral cavity. The lesion was located in the tonsil of a 20-year-old woman with a chief complaint of a painless, white lump in the back of the mouth for nine months. Discussion. The differential diagnosis of a white lesion on the palatine tonsil is caused by several factors, such as bacterial, viral, and fungal infections; trauma; stones; cysts; abscess; or cancer. In this case, both the clinical presentation and extra- and intraoral examinations were highly associated with LEC. Oral LEC etiopathogenesis is uncertain, and several theories have been proposed to discuss the causes of LEC. In addition, oral LEC could be monitored without surgical intervention if the nodule is asymptomatic. Conclusion. We emphasize the importance of a thorough clinical examination of oral and oropharyngeal lesions, which are usually neglected.

scholarly journals Role of S-100 Immunostain as An Auxiliary Diagnostic Aid in Leprosy

2017 ◽  
Vol 56 (205) ◽  
pp. 141-144 ◽  
Author(s):  
Ramesh Dhakhwa ◽  
Sneh Acharya ◽  
Sailesh Pradhan ◽  
Sanju Babu Shrestha ◽  
Tomoo Itoh
Keyword(s):  
Erythema Nodosum ◽  
Lupus Vulgaris ◽  
Common Pattern ◽  
Tissue Sections ◽  
Histopathologic Diagnosis ◽  
S 100 ◽  
Skin Biopsies ◽  
Hematoxylin And Eosin ◽  
Hematoxylin And Eosin Stain

Introduction: Histopathologic diagnosis of leprosy is difficult when Bacillary Index (BI) is zero and neural involvement are not easily identifiable on routine Hematoxylin and Eosin stain. This study was undertaken to study the role of S-100 immunostaining in demonstrating different patterns of nerve involvement in various types of leprosy. Methods: Thirty one skin biopsies with clinico-histopathologic diagnoses of leprosy over a period of two years were included in the study. Ten cases of non-lepromatous granulomatous dermatoses (including eight cases of lupus vulgaris and two cases of erythema nodosum) were used as controls. Tissue sections from all cases and controls were stained with Hematoxylin and Eosin (H&E) stain, Fite stain and S-100 immunostain. The H&E stained slides were used to study the histopathological features, Fite stained slides for Bacillary Index and S-100 for nerve changes. Results: Neural changes could be demonstrated in the entire spectrum of leprosy using S-100 immunostaining. The most common pattern of nerve destruction in the tuberculoid spectrum was fragmented and infiltrated whereas lepromatous spectrum showed mostly fragmented nerve twigs. Intact nerves were not detected in any of the leprosy cases. Conclusions:  S-100 immunostain is a useful auxiliary aid to the routine  H&E stain in the diagnosis of leprosy especially tuberculoid spectrum and intermediate leprosy.  Keywords: bacillary index; leprosy; S-100 immunostain.

A STUDY OF CLINICALAND MYCOLOGICAL PROFILE OF TINEA INFECTIONS

2021 ◽  
pp. 1-2
Author(s):  
Thappeta Deepak Tony Raj ◽  
Vennapusa Sravan Kumar Reddy ◽  
Chappidi Bhargavi
Keyword(s):  
Clinical Presentation ◽  
Skin Diseases ◽  
Fungal Infections ◽  
Geographic Location ◽  
Common Symptom ◽  
General Physical Examination ◽  
Direct Microscopic Examination ◽  
The World ◽  
General Physical ◽  
Dermatophyte Infection

INTRODUCTION: Dermatophytic infections, also known as ringworm, is one of the most common fungal infections of the skin around the world. The most common symptom seen with dermatophyte infection is pruritis. The varied presentation of tinea is often confusing with other skin diseases. It may be due to the irrational application of broad-spectrum steroid ointments and creams, leading to misdiagnosis and mismanagement. This study was begun to know the prevalence, clinical, and mycological prole of various dermatophytes OBJECTIVES OFTHE STUDY: 1.To study the prevalence of tinea infections. 2.To study the clinical presentation of patients with tinea infections. 3.To study the mycological prole of various tinea infections. METHODS: Clinical assessment was done, which include a detailed history, general physical examination, and examination of the lesion. After a complete review, the evaluation took place. Direct Microscopic Examination. Culture helps in the identication of species. CONCLUSION: To conclude, dermatophytosis is very common in India. It has been registered all over the world but with a different distribution, incidence, and epidemiology from location to location. Geographic location, climate, overcrowding, health care, immigration, personal and environmental hygiene, culture, and socioeconomic status have been attributed as major risk factors for these variations

Efficacy of Early Administration of Liposomal Amphotericin B in Patients with Septic Shock: A Nationwide Observational Study

2020 ◽  
Author(s):  
Masato Tashiro ◽  
Takahiro Takazono ◽  
Yuki Ota ◽  
Tomotaro Wakamura ◽  
Akinori Takahashi ◽  
...  
Keyword(s):  
Septic Shock ◽  
Amphotericin B ◽  
Liposomal Amphotericin ◽  
Fungal Infections ◽  
Survival Rates ◽  
Liposomal Amphotericin B ◽  
National Database ◽  
Shock Onset ◽  
Significant Difference ◽  
Nationwide Observational Study

Abstract To determine the most suitable time to initiate liposomal amphotericin B (L-AMB) treatment in patients with invasive fungal infections, patients with septic shock treated with L-AMB were identified from the Japanese Diagnosis Procedure Combination national database to determine their survival rates following septic shock onset, mortality during shock, and shock cessation period. We identified 141 patients administered L-AMB: 60 patients received treatment on the day of septic shock onset (early L-AMB group), whereas 81 patients received treatment after the onset (delayed L-AMB group). Survival rates after septic shock onset were higher in the early L-AMB group than in the delayed L-AMB group (4 weeks: 68.4% vs 57.9%, P=0.197; 6 weeks: 62.2% vs 44.5%, P=0.061; 12 weeks: 43.4% vs 35.0%, P=0.168, respectively). Mortality during septic shock was significantly lower in the early L-AMB group than in the delayed L-AMB group (13% vs 42%, P<0.001), with a significant difference confirmed after adjusting for confounding factors (odds ratio: 0.240, 95% confidence interval: 0.096-0.601, P=0.002). Septic shock cessation period was shorter in the early L-AMB group than in the delayed L-AMB group (7.0±7.0 days vs 16.5±15.4 days, P<0.001). L-AMB administration at septic shock onset could be associated with early shock cessation and decreased mortality.

scholarly journals Covid-19-Associated Pulmonary Aspergillosis: The Other Side of the Coin

Vaccines ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 713
Author(s):  
Claudio Costantini ◽  
Frank L. van de Veerdonk ◽  
Luigina Romani
Keyword(s):  
Immune Response ◽  
Clinical Presentation ◽  
Fungal Infections ◽  
Critical Factor ◽  
The Other ◽  
Current View ◽  
Immune Homeostasis ◽  
Pulmonary Aspergillosis ◽  
Secondary Infections ◽  
The Individual

The immune response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a critical factor in the clinical presentation of COVID-19, which may range from asymptomatic to a fatal, multi-organ disease. A dysregulated immune response not only compromises the ability of the host to resolve the viral infection, but may also predispose the individual to secondary bacterial and fungal infections, a risk to which the current therapeutic immunomodulatory approaches significantly contribute. Among the secondary infections that may occur in COVID-19 patients, coronavirus-associated pulmonary aspergillosis (CAPA) is emerging as a potential cause of morbidity and mortality, although many aspects of the disease still remain unresolved. With this opinion, we present the current view of CAPA and discuss how the same mechanisms that underlie the dysregulated immune response in COVID-19 increase susceptibility to Aspergillus infection. Likewise, resorting to endogenous pathways of immunomodulation may not only restore immune homeostasis in COVID-19 patients, but also reduce the risk for aspergillosis. Therefore, CAPA represents the other side of the coin in COVID-19 and our advances in the understanding and treatment of the immune response in COVID-19 should represent the framework for the study of CAPA.

The Clinical Presentation of Oral Potentially Malignant Disorders

2016 ◽  
Vol 5 (1) ◽  
pp. 52-57
Author(s):  
Neal J Mccormick ◽  
Peter J Thomson ◽  
Marco Carrozzo
Keyword(s):  
Oral Cancer ◽  
Clinical Presentation ◽  
Screening Programme ◽  
Survival Rates ◽  
Oral Potentially Malignant Disorders ◽  
Clinical Appearance ◽  
Potentially Malignant Disorders ◽  
Potentially Malignant ◽  
The Uk ◽  
Dental Appointments

Early detection of oral cancer improves survival rates significantly, however, the incidence of oral cancer has continued to rise in the UK – between 2002–2012, it increased by more than 30%.1 There is currently no national screening programme for oral cancer, so undertaking a full examination of the oral mucosa during routine dental appointments is vital. Although strong evidence is still lacking, oral cancer is thought to be preceded by oral potential malignant disorders (OPMDs) or oral precancerous diseases. These mainly present as white/red lesions within the mouth and their clinical appearance can be challenging to diagnose accurately, which can lead to them being misdiagnosed as negligible problems. Dentists must keep up to date with OPMDs detection and ensure they are capable of correctly recognising lesions that carry a potential risk. This paper aims to provide a brief overview on OPMDs, highlighting potentially malignant disorders as they may present to the practitioner, showing their typical clinical appearance, and suggesting differential diagnosis and clinical management in dental practice.

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