Facial Swelling Research Articles

Backgroud: Liver abscesses caused by Klebsiella pneumoniae associated with dental implant surgery are rare. We report a case of liver abscess and septic pneumonia caused by K. pneumoniae in a patient who developed a peri-implant abscess following dental implant surgery. Methods: The 69-year-old male patient underwent a dental implant surgery on the upper right first premolar 10 days prior to admission, and the toothache and facial swelling worsened 5 days before admission. Results: One day before admission, a peri-implant abscess was diagnosed at a local dental clinic, and the patient underwent irrigation and drainage. On the day of admission, the patient visited our dental department and was admitted through the emergency room due to melena. The patient underwent further irrigation and drainage of the peri-implant abscess around the upper right first premolar. A liver abscess in segments 2/3 (3.1 cm) and septic pneumonia were diagnosed, and K. pneumoniae was identified in the blood and sputum cultures. The patient received antibiotic therapy (piperacillin-tazobactam, meropenem, and ceftriaxone, sequentially) without percutaneous drainage of the liver abscess due to the patient’s refusal and recovered without complications. The patient was administered ciprofloxacin for 5 months after discharge. One month after admission, the inflammatory maker returned to within reference range. The patient improved with long-term antibiotic treatment alone without drainage of the liver abscess. To our knowledge, this is the first report of a liver abscess caused by K. pneumoniae originating from a peri-implant abscess after dental implant surgery. Conclusions: Clinicians should be aware of the potential occurrence of liver abscesses caused by K. pneumoniae if signs of systemic infection persist along with peri-implant infection after dental implant surgery.

Background/Objectives: Idiopathic edema (IE) in women is characterized by swelling of hands and face followed by increasing abdominal and truncal girth, bloating, edema, >1.4 kg weight gain when in upright posture, and nocturia that eliminates the retained fluid. A capillary leak is the primary pathophysiologic abnormality that induces different clinical presentations that were considered untreatable. Methods: We utilized different aspects of Starling forces of edema formation and treated four uncomplicated cases of IE by reducing salt intake with or without diuretics and two cases of life-threatening cases due to seizures and coma induced by acute hyponatremia in one and postural dizziness, fainting, and fractures and dislocations of joints in another. Results: All four uncomplicated cases of IE were treated by reducing salt intake with or without diuretics that eliminated the weight gain and nocturia. The patient with hyponatremia never developed hyponatremia by reducing water intake and signs and symptoms of IE by salt restriction and diuretic therapy and eliminated the postural hypotension, falls, and fainting by use of support hose that increased interstitial hydrostatic pressure to eliminate fluid shifting from intravascular to interstitial spaces. Conclusions: A leaky capillary induces pathophysiologic changes that activate different metabolic pathways. IE is now a treatable condition, following: 1. Salt restriction with or without diuretics for the cyclical weight gain, and 2. Water restriction for hyponatremia, hyponatremic seizures, and coma and 3. support hose for postural hypotension, postural dizziness, and fainting. IE is unrecognized and probably more common than it is perceived.

Disclosure: P. Kukunoor: None. M. Katta: None. B. Korlakunta: None. S. Kotharu: None. R. Devulapally: None. H. Bunga: None. D. Korlakunta: None.Background: This case study explores a rare complication of long-standing, untreated hypothyroidism Van Wyk–Grumbach syndrome [VWGS] which is often misinterpreted due to its overlapping symptoms with other endocrine disorders. Hypothyroidism may contribute to metabolic disturbances, that may exacerbate T1DM and lead to frequent DKA episodes.[1]Case Presentation:A 12-year-old female born from a 1st degree consanguineous marriage presented with a 45-day history of progressive shortness of breath, initially grade 1, worsening to grade 4 in 2 days. The associated symptoms are chronic constipation (2-3 times/week), excessive sleepiness, and swelling of both legs. She is diagnosed with T1DM at 3 years of age with a history of frequent hospitalizations due to DKA. Menarche is attained at 10 years of age with infrequent and irregular cycles.On clinical examination, the patient had disproportionate short stature (<3rd percentile) with an upper/lower segment ratio of 1.2. Axial/pubic hair was absent with no breast bud development indicating a sexual maturation rate of A1B1P1. Other findings included a depressed nasal bridge, dry skin, pallor and non-pitting generalized edema with facial puffiness. Laboratory investigations revealed severe anemia (Hb 4.5 g%), overt hypothyroidism (markedly elevated TSH, low free T4, anti-TPO antibodies positive), hyperglycemia (serum glucose 560 mg/dL), decreased LH and increased FSH levels and hypercholesterolemia. Imaging studies revealed bilateral polycystic ovaries, significantly delayed bone age, mild pericardial effusion and fatty liver. These features of hypothyroidism, isosexual precocious puberty, and delayed bone age, collectively point toward the classic triad of VWG syndrome. The patient was given a packed red blood cell transfusion for anemia, levothyroxine therapy (37.5 mcg/day), and insulin dosage adjustments. After 2 months, the patient showed marked remission of symptoms, indicating a positive response. Continued monitoring is essential to ensure sustained recovery. Conclusion: VWGS is a rare complication of hypothyroidism, characterized by diverse manifestations and associations, posing a significant diagnostic challenge. However, being a preventable condition, this case highlights early diagnosis and prompt treatment are essential to prevent morbidity and long-term complications. Hypothyroidism can frequently occur in association with T1DM, necessitating routine thyroid screening.[1]Reference:1.Al Jabri A, Al Johar A, Yacoubi MT. A Rare association of Mauriac syndrome and Van-Wyk Grumbach syndrome found in a young Saudi girl with poorly controlled type 1 Diabetes and Hypothyroidism: A Case Report and Brief literature review. Integr J Med Sci. 2023 Jan15Presentation: Sunday, July 13, 2025

Disclosure: N. Bang: None. M. Diab: None. J. Lim: None.Introduction: Crooke cell adenoma (CCA) is an uncommon but aggressive form of corticotroph adenoma comprised of Crooke cells that secrete ACTH that contribute to Cushing disease. There have been 106 documented cases of this condition (1). Crooke cells are comprised of cytoplasmic granules containing hyaline. CCA is diagnosed when over half of the cells exhibit these cytological changes. Crooke cells are immunopositive for the transcription factors T-PIT and CK8/18, as well as for ACTH. Case Description: A 57 y/o woman with a history of primary hypothyroidism presented to the emergency department for impaired peripheral vision, fatigue, facial swelling, and weight gain. Her brain MRI revealed a pituitary macroadenoma that was 2.8 cm x 3.7 cm x 4.1 cm in size with encasement of the left internal carotid artery. The endocrinology team evaluated the patient for pituitary hormonal disorders. The morning cortisol and ACTH levels were both elevated at 19.1 mcg/dL (6.2 to 19.4 mcg/dL) and 209 mcg/dL (7.2 to 63.3 mcg/dL), respectively. The 24-hour urine cortisol level was high at 362 mcg (6 to 42 mcg/24 hr). These findings were concerning for Cushing disease. The patient subsequently underwent transsphenoidal resection of her pituitary mass. The tumor pathology revealed a corticotroph adenoma with positive staining for ACTH, CK8/18, and T-PIT. After surgery, the patient developed partial hypopituitarism leading to arginine vasopressor deficiency and secondary adrenal insufficiency. The patient is being closely monitored for either persistence versus recurrence of Cushing disease. Discussion: This case shows that it is important to consider CCA in the differential when treating patients with Cushing disease. CCA can be challenging to treat, as the recurrence rate can be greater than 60 percent (2). CCA can transform into Crooke cell carcinoma, which can contribute to dural metastases. Complications of hypercortisolism impair quality of life and increase patient’s mortality. It is crucial to understand how to identify patients who are at considerable risk of developing Crooke cell changes. However, there are currently no clinical recommendations available to guide this. Findings from this study (3) can be used to understand the management of CCA. This will make it easier for clinicians to recognize and to manage CCA in their practices. 1 Taiwo A, Kamalumpundi V, Becker N, et al. Pituitary crooke cell adenoma: Two cases of an aggressive pituitary adenoma. JCEM Case Rep. 2023;1(6): luad114. 2 Olivera CB. The 2022 WHO classification of tumors of the pituitary gland: An update on aggressive and metastatic pituitary neuroendocrine tumors. Brain Pathol. 2025;35(1): e13302. 3 Heaney AP. Clinical review: Pituitary carcinoma: Difficult diagnosis and treatment. J Clin Endocrinol Metab. 2011;96(12): 1064.Presentation: Sunday, July 13, 2025

Disclosure: A. Rothstein Costris: None. F. Manas: None. S. Athimulam: None.Introduction: Bilateral adrenal adenomas are found in up to 20% of patients with incidental adrenal nodules and often cause ACTH-independent mild autonomous cortisol secretion (MACS). While MACS patients may not exhibit obvious hypercortisolism symptoms, they can still experience metabolic, cardiovascular, and bone-related complications. Treating these adenomas is challenging; bilateral adrenalectomy is not recommended due to high morbidity and lifelong adrenal replacement needs. Medical treatments like steroidogenesis inhibitors or glucocorticoid receptor antagonists are still under investigation. Unilateral adrenalectomy is an option, but choosing which gland to remove lacks clear guidelines. Typically, the largest gland is removed, though it may not always be the primary source of excess cortisol. We present a case of bilateral adrenal nodules treated with adrenal venous sampling (AVS) and successful unilateral adrenalectomy, leading to symptom and biochemical improvement. Case Presentation: 56-year-old female with bilateral adrenal nodules (largest nodule 2.5cm on the right side, HU<10), resistant hypertension, obesity, osteopenia, and chronic kidney disease, presented with worsening symptoms of flushing, palpitation, facial swelling, weight gain, sweating, and tremors for the past 6 years. Prior work up was negative for catecholamine excess. She had abnormal cortisol levels post dexamethasone suppression test (DST). She had repeated DST multiple times and results were persistently elevated. 2 out of 3 late night salivary cortisol tests were abnormal. 24-hour urine cortisol was within normal range. Her ACTH and DHEAS levels were suppressed. She was diagnosed with ACTH-independent mild autonomous cortisol secretion. She underwent adrenal venous sampling (AVS) with dexamethasone suppression to evaluate for lateralization. The result of AVS was consistent with right adrenal gland dominance for cortisol production. She underwent partial right adrenalectomy to reduce the cortisol burden and improve excess cortisol related co-morbidities. In the post-operative period, she had an episode of hypotension and was started on hydrocortisone which was gradually tapered over 2 months. Her ACTH level improved from 3 pg/ml to 17 pg/ml (normal 7-63 pg/ml). Her blood pressure also improved, allowing her to reduce the number of medications from four to two. Discussion: Adrenal venous sampling is a minimally invasive test which helps determine if excess cortisol production is unilateral or bilateral, and decide further management in patients with bilateral adrenal adenomas with ACTH-independent mild autonomous cortisol secretion. When lateralization is confirmed on AVS, it can be treated with curative unilateral adrenalectomy leading to better outcomes for the patient. Transient adrenal insufficiency can be seen in patients due to suppressed ACTH after the surgery.Presentation: Saturday, July 12, 2025

Disclosure: H. Angammana: None. M. Park: None. J. Pesantez: None. A. Sajan: None.Introduction: Myxedema coma is a rare endocrine emergency characterized by profound hypothyroidism with high mortality, often precipitated by infection, medication noncompliance or systemic illness. We present a case of refractory fatal myxedema coma complicated by acute hypoxic respiratory failure, septic shock and multiorgan failure. Case Presentation: A 79-year-old female with a history of hypothyroidism presented with progressively worsening lethargy for few days. She had been noncompliant with levothyroxine for several months. On admission, she was obtunded, hypothermic (90.5 °F), bradycardic (46 beats per minute), and hypotensive (88/50 mmHg). The physical exam revealed facial puffiness, periorbital edema, and generalized non-pitting edema. The laboratory findings were significant for Thyroid Stimulating Hormone (TSH) of 74 IU/mL [0.4-4.0] and free thyroxine (FT4) of 0.27 ng/dL [0.8-1.8]. She also had elevated white blood count (18.2 x10^9/L [4-11 x10^9]), elevated creatinine of 2.1 mg/dL [0.6-1.1], and hyponatremia (127 mmol/L [135-145]). She developed pneumonia with worsening respiratory distress and was intubated for airway protection. Shortly after, she had a lower gastrointestinal bleed requiring multiple blood transfusions. The patient was promptly started on intravenous levothyroxine, liothyronine, hydrocortisone, antibiotics and supportive care. Following initial stabilization, her TSH had improved to 4.76 IU/mL and mental status improved. She was subsequently downgraded to the general medical floor. However, she soon deteriorated in a few days with acute kidney injury requiring renal replacement therapy, newly diagnosed heart failure with a reduced ejection fraction (20%), bilateral pleural effusions and decubitus ulcers with osteomyelitis. She reverted to being lethargic and had a cardiac arrest secondary to aspiration. Given her poor prognosis, care was transitioned to comfort measures, and she passed away under hospice care. Her last drawn TSH was 13.83 IU/ml while on intravenous levothyroxine and liothyronine. Discussion: Myxedema coma continues to have a high mortality rate of about 50%. Predictors of poor prognosis include advanced age, persistent hypothermia, hypotension, bradycardia, sepsis, mechanical ventilation. The prognosis of myxedema coma remains difficult to determine due to its rarity. While early diagnosis and aggressive management have improved survival rates, complications such as sepsis, respiratory failure, and multiorgan dysfunction still result in poor outcomes like in our patient. Further research is needed to refine prognostic models and explore novel therapeutic strategies to improve survival in these patients.Presentation: Monday, July 14, 2025

Abstract Disclosure: D.L. Torres-Pinzon: None. L. Song: None. N. Mogar: None. Prolonged exposure to exogenous glucocorticoids contributes to secondary adrenal insufficiency, while chronic use of supraphysiologic doses can lead to iatrogenic Cushing’s syndrome (ICS), typically associated with oral or parenteral steroids for autoimmune or inflammatory diseases. Rarely, ICS has been reported from hidden steroid exposure in supplements. We discuss the case of a patient who developed Cushing’s syndrome after using a foreign herbal supplement labeled for pain management. A 54-year-old female with fibromyalgia, hypertension, hyperlipidemia, obesity, and type 2 diabetes presented with fatigue, weight gain, and laboratory findings consistent with secondary adrenal insufficiency with AM cortisol 0.7 mcg/dL (ref. 4 - 22 mcg/dL), adrenocorticotropic hormone (ACTH) level &amp;lt;5 pg/mL (ref. 6 - 50 pg/mL), and cosyntropin stimulation test (CST) with 1-hour peak cortisol of 13.2 mcg/dL (ref. &amp;gt;14.6 mcg/dL) while off of steroids. MRI revealed a small pituitary gland but no pituitary mass. She was started on hydrocortisone, which was later discontinued due to intolerance, and she was then transitioned to prednisone 5 mg daily. Within one week, she developed facial swelling, increased appetite, leg swelling, neuropathy, palpitations, hypertension, and hyperglycemia, prompting discontinuation of prednisone. The patient then presented to our clinic for further work up, and on initial evaluation, she had a BMI of 39.87 kg/m², moon facies, supraclavicular and dorsal fat deposition. She had discontinued steroids two months prior to her presentation but revealed that she had been taking fifteen different herbal supplements. Repeat laboratory evaluation revealed a suppressed AM cortisol (0.3 mcg/dL) and ACTH (3 pg/mL), elevated serum dexamethasone (886.1 ng/dL, ref. &amp;lt;50 ng/dL), TSH 0.19 mIU/L (ref. 0.3 - 4.7 mIU/L), and free T4 1.1 ng/dL (ref. 0.8 - 1.7 ng/dL). Discontinuation of all supplements led to improvement in labs after four weeks AM cortisol 6.6 mcg/dL, ACTH 25 pg/mL, dexamethasone &amp;lt;20 ng/dL (ref. &amp;lt;20 ng/dL), TSH 1.19 mIU/L and free T4 0.9 ng/dL. Laboratory analysis of all fifteen supplements confirmed the presence of high levels of dexamethasone in one supplement from the Ivory Coast labeled “Pain Medication”. A repeat CST is in process. Exposure to high levels of dexamethasone in this herbal supplement used to treat chronic pain led to secondary adrenal insufficiency (AI) with subsequent development of ICS and subclinical hyperthyroidism from steroid-induced TSH suppression. Stopping the culprit supplement resulted in improvement in the HPA axis and normalization of thyroid function. Iatrogenic cushing syndrome from unintentional steroid exposure in supplements is rare but increasingly prevalent with the rise in herbal/dietary supplement use. Thorough history-taking, including potential exposures to supplements, is critical to avoid missed diagnoses of ICS. Presentation: Monday, July 14, 2025

Disclosure: N. Chand: None. R. Yan: None. S. Cholekho: None.Introduction: Cyclic Cushing's syndrome (CCS) is a rare disorder characterized by episodic hypercortisolism alternating with normal cortisol levels, which poses significant diagnostic challenges. It mainly affects women and can lead to serious metabolic and cardiovascular issues. Understanding its cyclical nature is vital for effective management. Method: We present a case of a 47-year-old female with a history of mammary adenosis and lung adenocarcinoma who underwent extensive evaluation for suspected CCS. Results: The patient initially showed no clear signs of hypercortisolism, indicating a subtle onset of CCS. Over 12 months, she developed bilateral adrenal nodules, recurrent facial edema, and mild weight gain.Imaging revealed an irregular right adrenal gland (2.9 × 2.4 cm) and a well-defined left adrenal gland (0.8 cm). Her 24-hour urinary free cortisol (UFC) was 201.7 µg/24 hr, and a dexamethasone suppression test showed ACTH at 1.70 ng/mL and PTC at 28.60 mol/L. Cortisol and ACTH levels fluctuated during hospitalization. After diagnosis, the patient underwent laparoscopic right adrenal tumor resection, revealing a cortical adenoma. Post-surgery, she received a tapering glucocorticoid regimen for one month. Three months later, hormone levels normalized, facial swelling diminished, and her weight decreased from 62 kg to 60 kg, indicating treatment efficacy. However, ongoing monitoring is essential due to recurrence risk. Conclusion: CCS presents unique diagnostic challenges because of its variable manifestations and remission phases. Treatment must be individualized based on hormonal dynamics, with careful monitoring for relapse. The lack of standardized diagnostic criteria complicates CCS identification, highlighting the need for increased clinician awareness, especially in high-risk groups. Further research is crucial to develop effective diagnostic protocols for CCS. Keyword: Cyclic Cushing syndrome, ACTH, Dexamethasone suppression test (DST), Adrenal adenoma.Presentation: Saturday, July 12, 2025

Drug Reaction with Eosinophilia and Systemic Symptoms syndrome is a rare, severe cutaneous adverse reaction characterized by widespread rash, fever, hematologic abnormalities, and potential multi-organ involvement. It is most often associated with anticonvulsants, sulfonamides, and allopurinol, while anti-tubercular drugs are rarely implicated. We report the case of a 66-year-old female with a history of tuberculous pericardial effusion who developed recurrent diffuse erythematous, non-blanchable maculopapular rashes with facial edema and systemic symptoms following re-exposure to anti-tubercular therapy. Her symptoms were temporally related to ATT administration, strongly supporting a diagnosis of ATT-induced DRESS syndrome. The patient’s past medical history included hypothyroidism and cerebrovascular accident, but no significant drug allergies. Clinical evaluation revealed fever, facial swelling, generalized pruritic rash, and systemic complaints without significant abnormalities on chest or abdominal examination. Prompt discontinuation of ATT and supportive management led to clinical improvement. This case underscores the importance of early recognition of DRESS, even with uncommon culprits such as anti-tubercular drugs. Given the global prevalence of tuberculosis, ATT-induced DRESS poses unique therapeutic challenges, particularly in balancing drug hypersensitivity management with effective tuberculosis treatment. Clinician awareness and timely intervention remain key to improving outcomes in this potentially life-threatening condition.

Utility of diagnostic sinus CT for diagnosis of invasive fungal sinusitis in immunocompromised children.

ABSTRACT Objective: To evaluate the efficacy of a single preoperative intramuscular injection of dexamethasone in reducing trismus, swelling, and pain following the surgical removal of impacted mandibular third molars. Materials and Methods: This research had 60 participants aged 18–30 years, all requiring bilateral extraction of mandibular third molars. A single-blind methodology was employed, assigning the right side as the test site to receive 4 mg of intramuscular dexamethasone, while the left side served as the control, receiving a placebo of sterile water. Assessments for pain, mouth opening, and swelling were conducted before the procedure and again on the 2nd and 7th postoperative days, utilizing the Visual Analog Scale (VAS), interincisal distance measurements, and specific facial landmarks for swelling evaluation. Results: The test site exhibited significantly lower pain scores compared to the control site on both the 2nd and 7th days. Mouth opening was significantly improved in the dexamethasone group, and facial swelling was significantly reduced by the 7th day (P &lt; 0.05). No adverse reactions were reported. Conclusion: A single preoperative dose of dexamethasone effectively reduces postoperative trismus, swelling, and pain, enhancing recovery and patient satisfaction. Its use is recommended for third molar surgeries to manage postoperative sequelae.

Introduction Ozonized sunflower oil is increasingly employed in the management of oral conditions due to its antimicrobial and immunostimulating properties. While topical use is generally considered safe, off-label applications, such as intrasulcular or periapical injections, may pose unexpected clinical risks. The aim of the present report was to describe an unusual complication due to an improper use of ozonated oil and its management. Case Description We, herein, report the case of a 67-year-old female presenting with facial swelling unresponsive to antibiotics and corticosteroids. Initial evaluation suggested an odontogenic abscess; however, ultrasonography revealed an irregular, avascular intramuscular collection with a surrounding hypoechoic halo. The patient disclosed prior treatment involving ozonized sunflower oil, raising suspicion of an inadvertent submucosal injection. Surgical drainage yielded brownish fluid, with microbiological analysis proving negative. A second aspiration was required due to residual swelling. The patient reported near-complete symptom resolution following the second intervention. This case highlighted the potential adverse outcomes of non-topical administration of ozonized oil, which is non-resorbable and may induce a foreign body inflammatory response. Ultrasonography played a key role in differential diagnosis and guided therapeutic intervention, which was successfully managed with needle aspiration. Conclusion Off-label injections of ozonized oil should be avoided. Ultrasound assessment is instrumental in diagnosis, and needle-driven aspiration may offer an effective, minimally invasive treatment.

Conidiobolomycosis is a rare tropical deep cutaneous mycosis characterized by dysmorphic facial involvement giving, in advanced forms, a “hippopotamus snout” appearance. We report the case of a patient presenting with conidiobolomycosis at Kara University Hospital in Togo. The patient, a 32-year-old farmer, presented with a 2-month history of progressive facial swelling associated with headache and clear rhinorrhea. Clinical examination revealed a swollen face with increased involvement of the upper lip, erythema and a clear nasal discharge. A tomodensitometry of the face and histological examination of a skin biopsy provided further support for the diagnosis of conidiobolomycosis. The patient was put on itraconazole 400mg/day with a good clinical evolution. To our knowledge, no case has ever been reported in Togo.

Background: Up to 20% of end-stage renal disease and 12% of the causes of chronic kidney diseases are related to primary nephrotic syndrome. Nephrotic syndrome is one such burning problem which effects the school going child due to exaggerated immune response like auto-immunity following a viral infection. The incidence is 2 to 7 per 1,00,000 children per year. Corticosteroids are frequently needed by patients to achieve remission, however many patients either relapse after remission or do not react to them. The better alternative is, however far from established. Objectives: To evaluate the efficacy of a multimodal Ayurvedic treatment for nephrotic syndrome patient. Methods: A 10-year-old boy, diagnosed case of primary nephrotic syndrome, with complaint of swelling of face, proteinurea and recurrent respiratory tract infection. Based on the patient's observed indications and symptoms, a treatment plan was developed. The protocol includes Ksheerpaka of herbal drugs powder (Yashtimadhu, Shatavari, Guduchi, Gokshura, Musta, Punarnava, Mandukparni and Vidari) along with Chandanasava, Punarnavasava, Gokshuradi Guggulu and Arogyavardhini Vati, Chandraprabha Vati orally, with some dietary modifications. Results: The treatment approach demonstrated success in reducing proteinuria and facial swelling. During the follow-up period, no unfavourable impacts were observed.

Facing a new reality: significant increase in necrotizing fasciitis in the post-covid era?

Buccal pad of fat, advanced platelet-rich fibrin, fibrin glue, and oxidized cellulose plug in the management of oroantral communication: A comparative clinical study.

Sialoendoscopy and the management of pediatric sialolithiasis.

Facial Swelling and Dyspnea as Presenting Symptoms for Non-Hodgkin’s Lymphoma

ObjectiveOne of the significant complications of COVID-19 is coinfection with opportunistic fungal pathogens such as mucormycosis, which can pose a serious threat to patient survival. This study aimed to evaluate the clinical features, treatment outcomes, and post-infection oral health-related quality of life (OHRQoL) in hospitalized patients with COVID-19-associated mucormycosis (CAM) at an educational health center in Rasht, Iran, between 2020 and 2023.Materials and MethodsThis cross-sectional study included patients diagnosed with mucormycosis based on clinical presentation, histopathological confirmation, and fungal culture results. Demographic and clinical data, along with treatment interventions, were extracted from medical records. Patients were later interviewed by telephone, and OHRQoL was evaluated using the Oral Health Impact Profile-14 (OHIP-14) questionnaire. Data were analyzed using SPSS version 26, with the significance level of 0.05.ResultsA total of 28 patients with CAM were included in the study. The most frequent clinical signs and symptoms were facial swelling, mucosal necrosis, tooth mobility, and postnasal discharge. The paranasal sinuses and maxillary bone were the most commonly involved sites. Functional endonasal sinus surgery (FESS) and maxillectomy were the most frequently performed surgical procedures. The mean OHIP-14 score was 26.39 ± 8.55. A significant association was found between maxillary involvement and OHIP-14 scores. ConclusionsDespite the severity of their condition, CAM patients reported relatively acceptable OHRQoL. Oral manifestations may be among the initial signs of mucormycosis; therefore, dentists may play a key role in the early detection of mucormycosis.

Patients with Melkersson-Rosenthal syndrome (MRS) experience prolonged periods of functional impairment due to partial or complete facial paralysis and orofacial oedema that interferes with their ability to eat, drink, taste, express emotions and speak. Younger children with MRS are at high risk of nasogastric feeding dependency and additional chronic feeding challenges due to the cumulative impacts of disease flares during the period when feeding skills and interest in foods are first developed. We present a case of a boy in early childhood who presented multiple times over a 4 month period with predominant symptoms of recurrent unilateral facial swelling and significantly reduced oral intake and who was eventually diagnosed with MRS.