Pediatric orbital cellulitis: Case report of an unusual etiology and pathogen

Orbital cellulitis is an uncommon condition with risks to sight and life. As a complication of maxillofacial injuries, the literature suggests this is only possible with fractures or direct inoculation, and there are no reports to the contrary. Here, we make the first report of a possible etiology by which orbital cellulitis developed in a 14-year-old boy even without skin breach or bony fractures; as well as a rare causative pathogen. He presented with facial abscess and progressive orbital cellulitis after blunt facial trauma, requiring functional endoscopic sinus surgery with needle aspiration of facial abscess externally. Cultures showed growth of Streptococcus constellatus/Parvimonas micra, and he received further antibiotics with full recovery. The pathophysiology of orbital cellulitis in this patient is attributed to vascular congestion and local pressure from maxillofacial contusion and maxillary hemoantrum, with impaired paranasal sinus ventilation encouraging anaerobic bacterial growth. Further progression led to facial abscess formation and intraorbital spread with orbital cellulitis. The pediatric demographic is injury-prone, and self-reporting of symptoms can be delayed. Hence, increased suspicion of complicated injuries and orbital cellulitis may be required when managing maxillofacial contusions so that prompt treatment can be given.

Congenital Tarsal Kink Syndrome: Literature Review and Case Report

Background: The congenital tarsal kink syndrome is a rare form of congenital upper eyelid entropion associated with cardiovascular, musculoskeletal or central nervous system disorders. This syndrome must be recognized and surgically treated as a perinatal emergency to avoid associated complications—corneal ulcer, corneal leucoma, secondary amblyopia and decreased vision among children. Methods: A literature review was conducted to clarify the diagnosis particularities and the corrective surgery options of the congenital entropion on the upper eyelid. Results: Four relevant studies were found by researching the Web of Science and PubMed databases up to November 2021 for “congenital tarsal kink syndrome” and “congenital upper eyelid entropion”. Conclusions: In this paper, we present a case of congenital unilateral entropion of the upper left eyelid in the context of a tarsal kink syndrome in a one-month old infant, manifested by the absence of eyelashes on the upper eyelid of the left eye, hyperlacrimation and conjunctival hyperemia. Essential in managing the upper eyelid entropion is protecting the cornea. Furthermore, correcting a tarsal kink is eminently surgical, choosing between open or closed procedures. Herein, we address the difficulty in the timely diagnosis of this uncommon condition and make formal recommendations based on all reported cases.

A Case Giving Proof of Pathogenesis of Abdominoscrotal Hydrocele: A Case Report

An abdominoscrotal hydrocele (ASH) is an uncommon condition characterized by cystic mass that occupies the scrotum and abdomen. The characteristic aspect is the presence of two hydrocele sacs in the abdominal cavity and the scrotum, and compression of one side causes enlargement of the other side, thereby connecting the two sacs. There are several hypotheses regarding the occurrence of ASH. However, the evidence of the hypotheses is lacking. The patient was a 52-year-old male. During observation of the right inguinoscrotal hydrocele, the patient complained of a palpable mass lesion on the right lower quadrant of the abdomen. Physical examination revealed ASH that occurred with the growth of the inguinoscrotal hydrocele. This was further confirmed by sequential imaging test thereby proposing the verification of cephalad extension of hydrocele. The surgical excision was recommended and inguinal exploration was performed under general anesthesia. No evidence of relapse was observed during the 2-year follow-up period after surgery. The present case proves the cephalad extension of hydrocele among other hypotheses on the etiology of ASH.

Nasal Septal Abscess Complicating Acute Sinusitis in an 8-Year-Old Child: A Case Report

Introduction: Nasal septal abscess (NSA) in the pediatric population is an uncommon condition, but it can cause devastating complications (such as potentially life-threatening intracranial infections and cosmetic nasal deformity). The objective of this study is to report a case of an pediatric patient presenting with NSA in association with frontal-ethmoid acute sinusitis and intracranial abscess. Method and Results: In this study, we report a case of an 8-year-old patient who progressed from spontaneous nasal septal abscess to sinusitis (maxillary, frontal and ethmoidal), cosmetic nasal deformity (destruction of septal cartilage) and intracranial complication. The purulent collection necessitated urgent surgical drainage and adequate medical treatment. Conclusion: Nasal septal abscess in children is a rare condition that necessitates early appropriate drainage in order to prevent severe life-threatening complications. Furthermore, in the growing child, in case of total destruction of the cartilaginous septum, immediate reconstruction with autologous cartilage graft is essential for normal development of the nose and maxilla.

A rare case report of psoas abscess in pregnancy in a tertiary centre

A psoas abscess in pregnancy is a relatively uncommon condition with nonspecific signs and symptoms. It may lead to serious complications if not diagnosed and treated promptly. Although spinal tuberculosis affects nearly half of skeletal tuberculosis patients, psoas abscess develops in only 5% of spinal tuberculosis cases. A clinical history and examination are used to make a diagnosis, which is then confirmed by microbiology and radiological findings. Here is an interesting case report on psoas abscess in pregnancy managed by pigtail catheter insertion and drainage.

A Review on Mucormycosis Disease & Its Treatment

Mucormycosis is an angio-intrusive disease brought about by the Mucorales organism. Even though it is an uncommon condition, it is turning out to be more normal among immunocompromised patients. Rhino-orbitocerebral, cutaneous, dispersed, gastrointestinal, and pneumonic structures would all be able to be found. Notwithstanding the lively treatment, there is a generally speaking expanded passing rate. The audit's significant objective and objective are as follows: Mucormycosis Overview and Etiopathogenesis, Fatality of Rhino cerebral Mucormycosis Strategies for determination and treatment have as of late progressed. Mucormycosis is more typical in seriously neutropenia patients and people who need phagocytic action. Notwithstanding, this isn’t true on account of Patients with AIDS19. It suggests that T lymphocytes are involved. They are insufficient in forestalling parasitic expansion. Just the neutrophils are impacted. Voriconazole treatment for quite a while, essentially among the People with malignant growths of the blood and bone marrow Transfers of undifferentiated hematopoietic cells are more regular. Besides, Mucormycosis can likewise be found in individuals who don’t have any manifestations Rhino-orbitocerebral, cutaneous, dispersed, gastrointestinal, and pneumonic structures would all be found. Notwithstanding the lively treatment, there is a generally speaking expanded passing rate. Mucormycosis results from various fungi that may be innocuous and primarily affect immunocompromised patients. For this reason, the clinician must have a high index of suspicion to diagnose this disease in any of its forms when it presents in a patient with these risk factors. Starting with the host’s features and the fungus’s tropism once it invades the host, this activity discusses the manifestations of Disease, appropriate evaluation/management of mucormycosis, and highlights the role of the interprofessional team in evaluating and treating patients with this condition.

Endoluminal vacuum therapy in the management of an esophago-pleural fistula as a complication of Boerhaave syndrome in a patient with eosinophilic esophagitis

Background Boerhaave syndrome is an uncommon condition that represents about 15% of all esophageal perforation. A subset of these patients has eosinophilic esophagitis, a chronic inflammatory disease of the esophagus, that carries a risk of perforation of about 2%. Esophageal perforations can rarely result in the development of an esophago-pleural fistula. Treatment of esophago-pleural fistula represent a challenge due to lack of high quality evidence and scarce reported experience. Endoluminal vacuum-assisted therapy could have a role in the management by using the same principle applied in external wounds which provide wound drainage and tissue granulation. Case presentation We report a unique case of a 24-year-old man with eosinophilic esophagitis complicated with an esophageal rupture who developed an esophago-pleural fistula and was successfully managed with a non-surgical approach using endoluminal vacuum-assisted therapy. To our knowledge this could be the first experience reported in a patient with eosinophilic esophagitis. Conclusion Endoluminal vacuum-assisted therapy might be an effective and novel strategy in patients with eosinophilic esophagitis and esophago-pleural fistula as a consequence of Boerhaave syndrome. Appropriately designed studies are required.

A Review on Pediatric Social Phobia and Selective Mutism

Selective mutism (SM) is a psychological disease that affects children and is defined by a complete lack of speech in certain social contexts while speech production appears normal in others. Separation anxiety disorder, social anxiety disorder (previously known as social phobia), agoraphobia, and panic disorder, as well as shyness and anxiety, can all be associated with selective mutism. SM is a rather uncommon condition. Estimates of its point prevalence have been found in clinic or school samples in a variety of countries, and typically range between 0.03 percent and 1.9 percent depending on the setting. To properly establish the disorder's diagnosis, clinicians can use the SM module of the Anxiety Disorders Interview Schedule for Children and Parents (ADIS-C/P) or the Schedule for Affective Disorders and Schizophrenia for Children (Kiddie- or K-SADS). Nonmedication and medication-based therapies are the two basic types of treatment for selective mutism. Psychodynamic therapy, behavioural therapy, and family therapy are among the most common nonmedication-based or psychotherapy treatments. Selective seratonin reuptake inhibitors (SSRIs) (fluoxetine in particular) have been demonstrated to improve mutism and anxiety when used as a treatment option. The study aims to evaluate and treat selective silence and social phobia in children.

A Novel 4q32.3 Deletion in a Boy: Additional Signs and the Role of MARCH1

The 4q deletion syndrome is an uncommon condition manifesting with broad clinical expression and phenotypic variability. We report a 5-year-old boy affected by 4q deletion syndrome who showed minor craniofacial features, growth failure, mild developmental delay, severe speech delay, and marked irascibility and aggressivity. Moreover, he showed precocious and crowded primary dentition, digital hyperlaxity, and congenital bilateral adducted thumbs, signs which were previously unreported in the syndrome. The array comparative genomic hybridization analysis revealed a 4q partial terminal deletion of ∼329.6 kb extending from 164.703.186 to 165.032.803 nt, which includes part of MARCH1 (membrane associated ring-CH-type finger 1) gene (OMIM#613331). Same rearrangement was found in his healthy mother. Clinical phenotype of the child and its relationship to the deleted region is presented with a revision of the cases having the same copy number losses from the literature and genomic variant databases.

Post Covid-19 and Dentistry Revealing the silent condition - Rhino Maxillary Mucormycosis

The author would like to highlight the uncommon condition of rhinomaxillary mucormycosis which presents with a common complaint of periodontal abscess. This is highly significant in the current global scenario of the Covid-19 pandemic, as this deadly condition if diagnosed timely (by the dental surgeon) can save lives and prevent serious lifelong morbidity. Acute lung damage in Covid-19 was controlled worldwide by administering corticosteroids. This led to transient hyperglycemia, which coupled with low immunity served as an ideal environment for the fungal spore’s growth and proliferation.1 Species like Candida, Aspergillus and Rhizopus are normally not virulent in healthy individuals but can cause disseminated fatal infections in an immune-compromised host.2 Infection caused by these opportunistic pathogenic fungi present with non-specific symptoms and are often difficult to diagnose. Mucormycosis is the third most common opportunistic fungal infection caused by Rhizopus.3 Two such cases reported to the Department of Periodontics, Maulana Azad Institute of Dental Sciences, New Delhi with similar oral findings and common history of Covid-19 recovery. Both the patients were on 3 weeks of steroid therapy during which they had transient hyperglycemia. After 4 weeks of recovery, they developed painful gum boil/s. Clinical findings revealed periodontal abscess and tooth mobility.