ABSTRACT
A 7-year-old boy presented with an annular verrucous plaque on the chin of 5 weeks duration. The lesion occurred after a bicycle accident and was unresponsive to antibiotics. Fungal culture grew Sporothrix schenckii. Sporotrichosis should be considered and fungal culture obtained whenever a nodule or plaque fails to respond to initial treatment.
Subject(s)
Bicycling , Chin/injuries , Sporothrix/isolation & purification , Sporotrichosis/etiology , Wounds and Injuries/microbiology , Accidents , Child , Chin/microbiology , Humans , Male , Sporotrichosis/pathology , Sporotrichosis/therapyABSTRACT
A rare case of oromandibular Rhizopus oryzae infection is described in a 55-year-old woman with acute myeloid leukaemia and decompensated diabetes mellitus. The infection developed during induction chemotherapy when the patient was neutropenic. She was treated with a combination of amphotericin B lipid formulation and caspofungin plus surgery. Debridement surgery included excision of the lower lip, chin, floor of the mouth, a portion of the tongue, as well as mandibular resection at the level of the horizontal branches. Eight weeks of combined antifungal therapy were followed by secondary prophylaxis with amphotericin B lipid formulation during consolidation chemotherapy after achieving complete response of both leukaemia and mucormycosis. Reconstructive surgery was carried out including insertion of a new biomaterial porous mandibular prosthesis, which showed excellent functionality after long-term follow-up, followed by several plastic surgery procedures once good tolerability and no adverse effects of the prosthesis were observed. This case shows that a well-coordinated multidisciplinary approach is critical to increase the chances of clinical success in this life-threatening infection.
Subject(s)
Amphotericin B/administration & dosage , Echinocandins/administration & dosage , Leukemia, Myeloid, Acute/complications , Mucormycosis/drug therapy , Mucormycosis/surgery , Antifungal Agents/administration & dosage , Caspofungin , Chin/microbiology , Chin/pathology , Chin/surgery , Drug Therapy, Combination , Female , Humans , Lipopeptides , Mandible/microbiology , Mandible/pathology , Mandible/surgery , Middle Aged , Mouth/microbiology , Mouth/pathology , Mouth/surgery , Mucormycosis/pathology , Necrosis , Plastic Surgery ProceduresABSTRACT
Autogenous bone particles can be obtained with bone collectors during implant osteotomy; however, collected bone particles contain oral microorganisms that may cause infectious complications. The purpose of this review was to summarize the clinical studies that have evaluated the degree of this contamination and the effectiveness of different decontamination methods. Stringent aspiration protocol, preoperative oral chlorhexidine rinse, and antibiotic prophylaxis are important precautions to be implemented when collected bone particles are to be implanted. Despite reducing contamination of collected bone particles, none of the methods described in the literature can completely decontaminate collected bone particles or prevent the risk of infectious complications. Further research is needed to identify more effective decontamination methods.
Subject(s)
Bone Transplantation , Chin/microbiology , Decontamination/methods , Tissue and Organ Harvesting/instrumentation , Tooth Socket/microbiology , Animals , Antibiotic Prophylaxis , Chin/surgery , Dental Implantation, Endosseous , Filtration/instrumentation , Humans , Mouthwashes , Osteotomy , Suction/instrumentation , Tissue and Organ Harvesting/methods , Transplantation, AutologousABSTRACT
An analysis of 377 sets of positive skin smears of leprosy patients was done to determine the minimum sites needed to detect all smear positive leprosy patients. A combination of earlobe and a selective site could pick up 95.5% of the patients. An additional smear from the forehead increased the sensitivity of 97.7%. The results suggest that the sites for skin smears may be reduced to a combination of the earlobe and one selective site smear from a skin lesion to be able to detect most smear positive leprosy patients.
