Cold abscess of dental origin in a 7-year-old child

Abscess related to an infected tooth is mostly associated with pyogenic infection, but sometimes, it can be asymptomatic and indicate a chronic condition. This case report shows cold abscess with a draining sinus due to dental origin. A 7-year-old female patient complained of pain with respect to grossly decayed tooth and recurrent swelling with no response to medications. After investigations and management of the lesion, it was concluded as abscess due to chronic granulomatous infection. Cold abscess is a classical manifestation of tuberculosis with no signs of inflammation. More than 60% of cases of this pathology occur in patients below 15 years old. It needs various clinical, histopathological, and laboratory investigations. Although rare, it should be considered as a differential diagnosis when no improvement occurs postroutine therapy to prevent serious complications. Furthermore, various precautions should be taken by the clinicians to prevent cross-infection.

Tuberous sclerosis with portal vein thrombosis, protein C and S deficiency.

A 29-year-old lady with a bad obstetric history and portal vein thrombosis, presented to the Skin OPD for facial lesions. On examination, angiofibromas on face, shagreen patch and periungual fibromas were observed. She also had dental pits and a retinal hamartoma. Investigations revealed hamartomas in the brain and kidney. Hematological work-up showed protein C and S deficiency with Factor V Leiden positivity. Except for the cutaneous symptoms, the patient did not have any clinical manifestations in other organs affected by tuberous sclerosis. A similar association of tuberous sclerosis with protein C deficiency has been reported in only one case in literature.