Pancreatic candidiasis in a cat

Case summary An 11-year-old female spayed Maine Coon cat was referred for assessment of hyporexia, weight loss, vomiting and diarrhoea. An abdominal ultrasound revealed an enlarged and hypoechoic pancreas containing two large fluid-filled structures. Fine-needle aspiration of the cyst-like structures was performed, and cytology revealed moderate-to-marked predominantly suppurative inflammation with yeast cells. Candida glabrata was cultured from the fluid. The patient was treated with oral itraconazole and the clinical signs resolved, although repeat abdominal ultrasound and cytology revealed persistence of the infected cyst-like structures. The patient remained asymptomatic for 8 months after the discontinuation of antifungal medications, despite the persistence of the pancreatic infection with C glabrata. Relevance and novel information To our knowledge, this is the first report of pancreatic infection with Candida species in a cat, followed by a chronic subclinical infection persisting for at least 8 months after treatment discontinuation.

Microbiome of Infected Cysts, Feces and Saliva in Patients with Autosomal Dominant Polycystic Kidney Disease: Case Reports

Background: Cyst infection is a frequent and serious complication of autosomal dominant polycystic kidney disease (ADPKD). It is often difficult to treat and can be fatal, but much is still unknown about this type of infection. Hematogenous spread via bacterial translocation in the intestine is considered to be the main cause, so intestinal flora may be involved. However, the exact role of the intestinal flora in cyst infection in ADPKD is unknown.Case presentation: We report a 66-year-old woman and a 56-year-old man with ADPKD who had severe hepatic cyst infection. We analyzed the microbiome of infected cyst content, feces, and saliva in these two patients. The microbiome of patient 1 showed various bacteria in an infected cyst, whereas that of patient 2 showed only one bacterium. In both patients, the composition of the microbiome of the cyst content was quite different from those of feces and saliva, and the main bacteria in the infected cyst content represented a small proportion of those in feces and saliva.Conclusions: Cyst infection in ADPKD can be caused by a single bacterium or multiple bacteria, and cyst content culture or blood culture may identify only some of the causative bacteria. The association between bacteria in cysts and those in feces or saliva remains uncertain, and further research on this topic is needed.

Recurrence of Primary Pulmonary Hydatidosis in the Left Lung with No Hepatic Involvement

Echinococcus granulosus is the most common cause of hydatid disease of the lung. Hydatid disease is endemic to the Mediterranean countries, Middle East, South America and Australia. After liver, lung is the 2nd most common organ involved in this disease.1 The main route of infection is infestation of the embryo which after passing through the duodenal wall enters into the portal vein or the peri duodenal and perigastric lymphatics. The pulmonary cysts develop through this route, secondary to hepatic lesions. 1 Pulmonary hydatidosis is most commonly seen in men during the 2nd and 3rd decades of life. An intact cyst can be defined as “simple or closed cyst”, and a ruptured and / or infected cyst“ can be defined as “complicated cyst”.2 Recurrence has been defined as new active cysts appearing after therapy, which includes reappearance with continual growth of live cysts at the site of a previously treated cyst or new distant disease appearing as a result of spillage.3 The diagnosis of hydatid cyst diagnosis is often delayed because patients are asymptomatic for years during the period of growth of the parasite.2 Surgical goals in a case of hydatid cyst are: A - total eradication of the parasite; B - the prevention of the cyst 's rupturing on the operative field and its consequent dissemination; and C - the extirpation of the residual cavity.4 In this article, we report a rare case of male patient with multiple daughter cysts in the left lung at pleura-parenchymal junction and mediastinum who presented to us with recurrent pulmonary hydatidosis, which has caused complication of expectoration of multiple daughter cyst of small size.

Calcium Hydroxide as Intracanal Medicament in Pulp Necrosis with Periapical Lesion : A Case Report

Calcium hydroxide [Ca(OH)2] has been widely used as an intracanal medicament especially in treatment of periapical lesion. This case report will discuss about calcium hydroxide as intracanal medicament in a periapical lesion of an upper left central incisor. This case describes about treatment of periapical lesion with suspect of infected cyst with symptoms and root resorption. Root canal preparation was done by crown down technique using protaper hands universal from S1/27mm until F5/27mm. Calcium hydroxide paste was continuously applicated every 2 weeks as intracanal medicament until the periapical index (PAI) of lesion decrease, in this case PAI decreased from scale 5 until scale 2 during three months recall. Calcium hydroxide supports tissue repair, stimulates fibroblast formation and damage the cytoplasmic membrane of bacteria, denature their proteins or damage the DNA by its alkaline property. As conclusion, the use of calcium hydroxide successfully decrease the periapical lesion index in the periapical radiograph examination and can be considered as a simple and effective medicament for endodontic infection.

Identification of Toxoplasma Gondii Cyst in Ras Chicken as A Potential Infection of Toxoplasmosis

Toxoplasmosis is a zoonotic diseases caused by Toxoplasma gondii,which spread out by cats and it can be found in fowl. It because the fowl swallowing food which had been infected byToxoplasma gondii oocyst. The most consumpted fowl is chicken.The source of data and agriculture information center showed that consumption of chicken was increased about 10,20%. It could be a potential increasement of Toxoplasma gondii infection. The objective of this research was indentificate the infection of Toxoplasma gondii cyst on ras chicken brain. The type of this research was a descriptive research, observe by examining 30 samples of the ras chicken brain by randomized sampling techniques. Based on research on 30 samples of the ras chicken brain, obtained positive results as much as 2 samples (6.6%) cyst infected of Toxoplasma gondii and others 28 samples of ras chicken brain (93.4%) were not infected with Toxoplasma gondii cysts. Positive results of Toxoplasma gondii can be caused due to maintenance system and cleanliness of chicken coop was much less, so there were carrier vectors contaminate to feed place, so there was a potential infection of Toxoplasmosis.It can be concluded that been 2 samples of chicken brain being infected cyst of Toxoplasma gondii or about 6,6% and there were 28 samples or 93,4% of chicken brain that were not infected by cyst of Toxoplasma gondii. Infection circle of Toxoplasmosis can be avoided by manage maintenance system of chicken and keep the cage cleamliness, also keep the personal hygiene and feeds.

The Central Neck Dissection or the Modified Sistrunk Procedure in the Treatment of the Thyroglossal Duct Cysts in Children: Our Experience

Background. The aim of the study was to present the surgical techniques providing the lowest recurrence rate in treatment of the primary and recurrent thyroglossal duct cyst (TGDC) in children. Methods. The study included 73 patients operated on because of TGDC in years 2011–2016. Ultrasound was performed in all patients preoperatively. In 8 patients with the recurrence of the disease, the CT or MR was carried out before the surgery. Children with the primary disease underwent the modified Sistrunk procedure. In the revision cases the central neck dissection was a method of choice. Results. In 45 children, the modified Sistrunk procedure was performed and 28 underwent the central neck dissection. In 2 patients, hematoma occurred after the modified Sistrunk procedure with the need of the surgical revision in one. No complications were observed after the central neck dissection. Conclusions. A modified Sistrunk procedure is method of choice in the treatment of the uncomplicated TGDC. In selected cases of the TGDC with a history of infected cyst or incision of an abscess or in revision cases the central neck dissection should be considered in order to avoid the risk of the further recurrences.

A case of third branchial cleft cyst

Branchial cyst or congenital cystic lesions of neck originate from branchial clefts, the 2nd branchial cleft cyst being the most common and 3rd and 4th being missed. Hence, they are often misdiagnosed as lymph nodal masses, cold abscess. We are reporting a case of 3rd Branchial cleft cyst, of a 12-year-old boy who presented with left sided recurrent painful cystic mass at the level of hyoid bone going down to the level of pyriform fossa. All the tests for tuberculosis were negative. USG neck revealed loculated thick walled cyst from SCM to lateral part of pharynx. CECT revealed a thick-walled cyst extending from the anterior border of the sternocleidomastoid going down obliquely below the level of thyrohyoid membrane to pyriform fossa. Exploration revealed a thick walled infected cyst, pushing left upper pole of thyroid medially and anterior to left sided superior laryngeal nerve. The cyst was going downwards medially below the level of thyrohyoid membrane. The cyst was excised completely. Histopathology revealed the findings of squamous epithelial lining of cyst wall and cholesterol crystals within. Detailed anatomy on CECT, surgery and histopathology confirmed 3rd arch Branchial cyst.

Etiology of Deep Neck Infection and Determination of their Predisposing Factors and Microbial Pattern

Deep neck infection is an infection in the potential spaces and fascial planes of either with abscess formation or cellulitis .However some of may still result in fatal complications. This paper described the etiology of deep neck infection, their predisposing factors and microbial pattern. More than 50% subject of this study were of younger age group ( below 40 years) with male predominance (65%). Regarding the neck space submandibular space was the most commonly involved(32%). Etiology of neck abscess showed that odontogenic cause was the most common (60%) among the respondent, then come infected cyst, tumour. Among the predisposing factors of deep neck infection, Anaemia comprises the highest percentage (45.2%). Then comes diabetes and Liver disease, Oral hygiene, index relates with the odontogenic cause. Among the odontogenic cause patient (71.8%) had poor oral hygiene index. Regarding microbial pattern streptococcus was the highest predominance followed by Staphylococcus and E coli. This results correlates with the common dental infective microorganism which also stands for odontogenic cause of deep neck abscess. This study concluded that maintenance of good oral hygiene can prevent deep neck abscess and their devastating effect of Bangladeshi people.Update Dent. Coll. j: 2016; 6 (2): 13-20