Infected Cyst Research Articles

SURGICAL MANAGEMENT OF GIANT RADICULAR CYST OF MAXILLARY CENTRAL AND LATERAL INCISOR FOLLOWED BY APICOECTOMY- A CASE REPORT

Radicular cysts are inflammatory odontogenic cysts of tooth bearing areas of the jaws. Most of these lesions involve the apex of offending tooth and appear as well-defined radiolucencies. Owing to its clinical characteristics similar to other more commonly occurring lesions in the oral cavity, differential diagnosis should include dentigerous cyst, ameloblastoma, odontogenic keratocyst, periapical cementoma and Pindborgtumour. Majority of these lesions engross the whole apex and appear as precise radiolucencies. The cystic lesion lined with the epithelium, which filled with fluid therefore, they are generally referred to as a true cyst. Based on clinical, radiographical and histopathological findings, the present case was diagnosed as an infected radicular cyst. The clinical characteristics of this cyst could be considered as an interesting and unusual due to its giant nature. The lesion was surgically enucleated without any postoperative complications and satisfactory healing, was achieved. Various mode of treatment available for radicular cyst management including surgical and non-surgical procedures, the present case report discuss the surgical management of radicular cyst of maxillary central and lateral incisors.

Nephrology Picture. Infected Liver Cyst in a Kidney Transplant Recipient with ADPKD

Nephrology Picture. Infected Liver Cyst in a Kidney Transplant Recipient with ADPKD

Infected Urachal Cyst in Adult

Infected urachal cyst is one of urachal spectrum abnormalities. It usually presents in children because obliteration normally happened at early infancy. Rare case occurs in adult either can be small incidence or unrecognized symptoms until adulthood. Only small numbers of literature reported. The urachus is a tube extending from the anterior roof of the vesica urinaria to the umbilicus along the midline. The urachus is a vestigial fibromuscular structure located anterior to the fascia transversalis and posterior to the peritoneum. The presence of an embryonic urachal remnant can result in a variety of clinical complications. Due to the rarity of urachal residual disorders and the possibility of vague stomach or urinary symptoms, it is difficult to make a firm preoperative diagnosis. A 32-year-old female was referred to Saiful Anwar General Hospital after suffering abdominal pain for two months; the perineum felt the pain. There was a history of dysuria and nausea since the previous month, but no history of fever or change in bowel habits. Abdominal ultrasound showed an abscess at the anterior bladder and MRI showed an infected cyst mass in the suprapubic pointing to the left umbilical. Partial cystectomy and uterus biopsy were performed. The histopathologic result showed chronic inflammation tissue, and no malignancy was found. Misdiagnosis may lead to many complications such as progressive infection until malignancy therefore early detection of this case is important.

VERY RARE COMBINATION OF PATENT VITELLOINTESTINAL DUCT WITH PATENT URACHUS

Introduction - The vitelline duct is the embryological narrow channel connecting the yolk sac with the intestine. During the foetal life, vitelline duct tends to obliterates itself till to disappear. The partial failure of this obliteration can lead to the development of a duct, a ligament, or a diverticulum known as a Meckel's diverticulum. A Patent omphalomesenteric duct occurs because of the complete lack of vitelline duct.[3] The urachus is an embryological remnant of the allantois. Between the fourth and fth month of gestation, the foetal bladder tends to descend gradually and its apical portion creates the urachus. The urachus obliterates itself, becoming the median umbilical ligament. Its persistence after intrauterine life can manifest as urachal remnants. A patent urachus is because of complete lack of obliteration of urachus [1,3]. The incidence of these anomalies PU was 1-2 per 10000 while PVD is 1 in 5000 to 8000 deliveries [1,3,5]. The association of both anomalies is very rare [7]. Case discussion- A 12-years-old male presented with complaints of pain in abdomen, multiple episodes of vomiting. Patient was tachycardiac with tenderness in right iliac fossa with palpable lump with ultrasonography suggestive of perforated appendix with lump formation and was managed conservatively and asked for interval appendicectomy with CECT abdomen. CECT was suggestive of normal and compressible appendix with infected urachal cyst. But after 4weeks patient had similar complaints hence posted for emergency operation with McBurney's incision not by midline incision to avoid injury to urachal cyst. Intra operative ndings-1) patent Vitello intestinal duct 2) patent urachus 3)15cc pus discharge near umbilical end of urachus 4) normal appendix and small bowel. Resection of Vitello intestinal duct and urachus with ileoileal anastomosis done and specimen sent for histopathology which was suggestive of patent vitello intestinal duct with changes of gangrene. The Patent Vitello Conclusionintestinal duct with patent urachus is very rarely seen in combination and its diagnosis may be missed preoperatively and should be kept as a possibility in patients with patent urachus with or without infection

Intestinal Barrier Repair in Giardiasis

Abstract Giardiasis is a common diarrheal disease caused by the protozoan parasite Giardia duodenalis. Acute symptoms can include diarrhea, but infections are often sub-clinical. It is transmitted via ingesting infectious cysts in contaminated food or water. In developing countries, giardiasis is one of the leading causes of growth stunting in children under two years old. Changes in intestinal barrier integrity have been shown to contribute to impaired nutrient absorption, thereby leading to growth stunting. Although intestinal barrier defects have been linked to infection, there is little understanding of barrier repair dynamics post-infection. Previous studies have demonstrated that Giardia infection is associated with dysbiosis in humans and animals. Because Aryl hydrocarbon receptor (AHR) signaling has been shown to promote intestinal repair in other systems, we are exploring the role of AHR in barrier repair following a Giardia infection. We quantified specific microbiome-derived AHR ligands in the plasma of infected C57BL/6 mice and observed a reduction of indole-3-ethanol and indole-3-pyruvic acid 21 days post-infection. Since IL-22 signaling can also promote barrier repair, we quantified IL-22 transcripts by RT-PCR and found significantly increased levels of IL-22 mRNA in infected mice. These data suggest that Giardia can reduce barrier repair through altered production of AHR ligands by the microbiome, but that IL-22 can counter this effect in some situations. This study will give better insight into developing effective dietary interventions to prevent growth stunting in infected children. Supported by grant from NIH AI166467

Kidney Transplantation After Renal Transcatheter Arterial Embolization for Cyst Infection in a Hemodialysis Patient With Autosomal Dominant Polycystic Kidney Disease: A Case Report

A 31-year-old woman with autosomal dominant polycystic kidney disease (ADPKD) required antibiotic therapy for repeated renal cyst infections. The patient was scheduled for a living donor renal transplant with her mother as the donor. Two months before surgery, the patient was admitted to the hospital due to a severe renal cyst infection that improved with antibiotic treatment and percutaneous drainage, but the scheduled surgery was postponed. Transcatheter arterial embolization (TAE) was performed to control repeated renal cyst infections. Seven months after TAE, the patient underwent living donor renal transplantation. The postoperative course was uneventful, and the patient was discharged from the hospital on immunosuppressive medication 26 days after surgery with no evidence of recurrent infection or deterioration of renal function. Thirty months after transplantation, there has been no recurrence of infection.

Protoscolicidal effects of curcumin nanoemulsion against protoscoleces of Echinococcus granulosus

BackgroundThe aim of the present study was to assess in vitro protoscolicidal effects of curcumin nanoemulsion (CUR-NE) against protoscoleces of cystic echinococcosis (CE)/hydatid cysts.MethodsThe CUR-NE was prepared via spontaneous emulsification of soybean as the oil phase, a mixture of Tween 80 and Tween 85 as the surfactant, ethanol as the co-surfactant and distilled water. Various concentrations of CUR-NE (156, 312, 625 and 1250 µg/ml) were exposed to collected protoscoleces of infected sheep liver hydatid cysts for 10, 20, 30, 60 and 120 min. Viability of the protoscoleces were assessed using eosin exclusion test. Morphological changes of the protoscoleces were observed using differential interference contrast (DIC) microscopy.ResultsThe mean particle size and zeta potential of CUR-NE included 60.4 ± 14.8 nm and − 16.1 ± 1.1 mV, respectively. Results showed that the viability of the protoscoleces decreased significantly with increases in CUR-NE concentrations (p < 0.001). The mortality rates of protoscoleces with exposure to concentrations of 1250 and 625 µg/ml of CUR-NE for 60 min were 94 and 73.33%, respectively. Mortality of the protoscoleces was 100% after 120 min of exposure to 1250 and 625 µg/ml concentrations of CUR-NE. Using NIC microscopy, extensively altered tegumental surface protoscoleces was observed after protoscoleces exposure to CUR-NE.ConclusionThe findings of the present study revealed the in vitro protoscolicidal potential of CUR-NE. Therefore, CUR-NEs are addressed as novel protoscolicidal agents, which can be used as an alternative natural medicine to kill the protoscoleces, owing to their low toxicity and significant inhibition potency. However, further studies are necessary to investigate pharmacologic and pharmacokinetics of CUR-NEs.

MANAGEMENT OF AN INFECTED RADICULAR CYST OF THE MANDIBLE: A CASE REPORT

Among all odontogenic cysts, Radicular cyst is the most common inflammatory odontogenic cyst. They develop from epithelial rests of malassez in the PDL, as a result of inflammation. It is a true cyst that occurs in association with the root of the non-vital tooth. An inflammatory response occurs in the periapical tissue, leading to resorption of bone and formation of granulation tissue which are infiltrated by inflammatory cells. Though treatment of choice for smaller cystic lesions involves endodontic therapy, massive cystic lesions don't heal completely with non-surgical endodontic treatment. Massive cystic lesions need Endodontic treatment followed by surgical decompression treatment. In this case report, we present the diagnosis and surgical management of an infected radicular cyst of the mandible.

Limitation of Jalauka (medicinal leech) application in the prevention of recurrence of keloid

Keloid can be defined as a benign dermal fibroproliferative disorder with no malignant potential. The keloids tend to occur following trivial physical trauma in genetically predisposed individuals. Jalauka (medicinal leech, Hirudo medicinalis) is famed to use in all skin disorders caused by vitiation of Rakta (~blood) and Pitta Dosha (a functional regulatory factor of the body). Many studies also have claimed that the saliva of medicinal leeches potentiates wound healing. It helps in healthy scar formation by inhibiting the conversion of fibrinogen to fibrin. Therefore, a hypothesis was made that medicinal leech application can be helpful in the healing of the wound without keloid formation in patients with keloid formation tendencies. In the present study, case of a 38-year-old male patient infected sebaceous cyst at the right upper back (scapular region) with a previous history of keloid formation after surgical scar was treated by weekly medicinal leech application five times after excision of the cyst under local anesthesia. Initiation wound healing was normal in the studied case until complete epithelization. After 2 months of complete healing, gradual hardening and shiny appearance with irregular margin became very prominent and seemed to convert in keloid, although other associated symptoms were absent. The findings of this case report indicate the limited effect of the medicinal leech application and the requirement of a multimodel therapeutic approach for healthy wound healing in keloid tendency patients.

REASONS FOR EXTRACTION OF MANDIBULAR THIRD MOLAR AT TERTIARY CARE CENTRE IN EASTERN NEPAL

Background: Mandibular third molar is unique as relatively large number are either malposed, impacted or underdeveloped. This characteristic often leads to higher prevalence of dental caries, periodontal diseases and pathological lesions such as cysts, tumours or space infections leading to extraction of mandibular third molars. The objective of this study was to assess the reasons for mandibular third molar extraction. Methods: A descriptive cross-sectional study was conducted on 146 patients from 1st August 2021 to 31st July 2022 in the department of Dental surgery of Birat medical college and teaching hospital. Data were analysed by Statistical Package for Social Sciences (SPSS) version 22. Results: Out of 146 patients 90 (61.6%) were females and 56 (38.4%) were males. Reasons for mandibular third molar extraction were dental caries (n=67; 45.9%), impaction (n=62; 42.5%), periodontitis (n=10; 6.8%) and others (n=; 4.8%) which included traumatic ulcer on the tongue (n=3; 2%), angle fracture of the mandible (n=2; 1.4%), dentigerous cyst (n=1; 0.7%) and fascial space infection (n=1; 0.7%). Conclusions: The most common reasons for extraction of mandibular third molar was dental caries. Most common reason for extraction in age ≤ 25 years was impaction and it gradually shifted to dental caries as age progressed. Impaction was the most common reason for extraction of mandibular third molar in males however it was dental caries in females.

Кістозні лімфатичні мальформації кишечника та брижі в дітей: особливості клінічного перебігу та лікувальна тактика

Lymphatic malformations (LMs) - are congenital vascular malformations caused by abnormal embryologic development of the lymphatic system with variable clinical manifestation. Abdominal LMs account approximately 5% of all LMs. The main treatment option for abdominal LMs is surgical. Purpose - to analyze our experience in intestinal and omental LMs diagnosis and treatment, to reveal factors that could influence the complications occurrence risks, that could improve abdominal LMs treatment results in children. Materials and methods. Among 240 pediatric patients, who underwent cystic LMs treatment in a period from December 2012 to July 2022, 43 (19.1%) were diagnosed abdominal and retroperitoneal LMs. 18 (41.8%) patients with intestinal and mesentery affection were included into the study group. Median follow up was 20.7 (95% CI: 12-27) months. Results. Male patients predominated in the study group. Median age at admission was 2.5 (95% CI: 0.75-5) years. 12 (66.6%) had an emergency admission. In 7 (38.8%) children LMs were complicated by intestinal obstruction (n=5; 71.4%), intracystic bleeding and LM cyst infection were observed in n=1, 14.3%) cases both. Surgical treatment was applied in 16 (88.8%) patients, among which 7 (43.7%) underwent laparoscopy. In 4 (25%) cases conversion to laparotomy took place, 5 (31.3%) underwent laparotomic surgeries. No recurrences after surgical treatment were observed. Systemic therapy with mTOR-inhibitors was prescribed in a child with symptomatic total mesentery affection, observational tactics was chosen for asymptomatic child. Conclusions. Intestinal and mesenterial LMs can be asymptomatic or manifest complications, which were observed in 7 (38.8%) children of our group. Macrocystic intestinal LMs are of higher risks of complications development (р=0.0236). Surgical treatment is effective for local intestinal and mesentery affection, excellent treatment result was achieved in 94.1% of patients. In cases with total mesentery affection mTOR-inhibitors systemic therapy is the treatment of choice. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

Intraperitoneal Rupture of Infected Cyst in a Patient with Polycystic Kidney Disease after Kidney Transplant: A Case Report

Intraperitoneal Rupture of Infected Cyst in a Patient with Polycystic Kidney Disease after Kidney Transplant: A Case Report

Infected Pigmented Meibomian Duct Cyst Masquerading as a Conjunctival Melanoma.

Infected Pigmented Meibomian Duct Cyst Masquerading as a Conjunctival Melanoma.

Infected Ruptured Parathyroid Cyst Presenting with Hypercalcemia and Airway Obstruction: A Case Report.

Parathyroid cysts (PC) are infrequently encountered and characterize less than 1% of all head and neck masses. When present, PCs may present as a palpable neck mass and lead to hypercalcemia and rarely respiratory depression. Furthermore, the diagnostics of PCs is difficult as they can masquerade as a thyroid or mediastinal mass given their proximity. PCs are theorized to be a progression of parathyroid adenomas and often routine surgical excision is sufficient for cure. To our knowledge, there is no documented report of a patient with an infected parathyroid cyst that led to severe dyspnea. This case describes our experience of a patient with an infected parathyroid cyst presenting as hypercalcemia and airway obstruction.

Conservative approach in the management of infected radicular cyst in the anterior maxilla in a pediatric patient: A case report

Odontogenic cysts are pathological cavities enclosed by fibrous connective tissue and lined with epithelial tissue that develops from odontogenic tissues in the maxilla and mandible's tooth-bearing regions. Trauma or tooth caries is the main cause of radicular cysts or periapical cysts. Pulp necrosis is the outcome of dental caries irritating the pulp cavity. Once the infection has reached the root's tip, it causes periapical periodontitis, which may lead to either a chronic granuloma or an acute abscess. A persistent chronic infection led to the development of a periapical cyst. Radicular cysts are the most prevalent cystic lesions that afflict the jaw. They account for 52% to 68 percent of all cysts affecting the human jaw, making them the most common of all jaw cysts. The paper presents a case report of a 10-year-old pediatric patient who developed a radicular cyst post-trauma and eventually got infected.

Acute renal intracystic hemorrhage in patients with autosomal dominant polycystic kidney disease.

Renal cyst bleeding is a frequent problem in patients with autosomal dominant polycystic kidney disease (ADPKD). However, information is still limitedon its frequency, causative factors, and effects on enlargement of polycystic kidneys in ADPKD. We investigated the total volume of acute renal intracystic hemorrhage and its association with total kidney volume (TKV) in a large seriesofpatients with ADPKD on dialysis, referred forrenal transcatheter arterial embolization. All patients had undergone CT scan and MRI scan before the procedure.We evaluated factors potentially associated with acute renal intracystic hemorrhage.The association between thevolume of acute renal intracystic hemorrhage and the potential predisposing and associated factors was analysed by univariable and multivariable regressions. RESULTS: We enrolled 199 patients who underwent renal transcatheter arterial embolization from 2014 to 2018 (107 men, 92 women; mean age 59.1 ± 8.6years). The median volume of acute renal intracystic hemorrhage was 97.3ml (interquartile range 36.6-261.7ml). Multivariable analysis revealed that body weight, kidney stones, systolic blood pressure, and total volume of acute renal intracystic hemorrhage were significantly associated with TKV; age, body mass index, smoking, renal cyst infection, serum alkaline phosphatase, and TKV were significantly associated withthe volume ofacute renal intracystic hemorrhage ; and sex, age, dialysis vintage, TKV, and total volume of acute renal intracystic hemorrhage were significantly associated with the number of microcoils required to achieve renal transcatheter arterial embolization. Total volume of acute renal intracystic hemorrhage was significantly associated with TKV(r = 0.15, p = 0.0325)and wasgreater inyounger patients (r= - 0.32, p < 0.0001). Total volume of acute renal intracystic hemorrhagewas also correlated with the number ofmicrocoils required for renal transcatheter arterial embolization(r = 0.23, p = 0.0012). Acute renal intracystic hemorrhage is frequent among ADPKD patients on dialysis, and total volume of acute renal intracystic hemorrhage significantly associated with TKV.Total volume of acute renal intracystic hemorrhage was greater in younger patients with higher renal artery luminal size. These results suggest that renal cyst bleeding and renal artery blood flow may synergistically accelerate the enlargement of polycystic kidneysin ADPKDpatients on dialysis.

In silico Analysis of a 29 kDa Echinococcus granulosus Protoscolex Protein (P29) as a Vaccine Candidate against Cystic Echinococcosis.

Vaccination can be a key step in controlling hydatid cyst infection in humans and livestock in endemic areas of the disease. The aim of the Present study was to determine some of the basal biochemical properties followed by prediction and screening of B-cell and MHC-binding epitopes of EgP29 protein in silico. Some of the basic physico-chemical properties along with antigenicity, allergenicity, solubility, post-translational modification (PTM) sites, subcellular localization, signal peptide, transmembrane domain, secondary and tertiary structures followed by refinement and validations were computationally determined for this protein. Also, B-cell epitopes were predicted and screened using various web servers, while MHC-binding and CTL epitopes were predicted using IEDB and NetCTL servers, respectively. The protein is a 238-residue, 27 kDa molecule, with high thermotolerance (aliphatic: 71.81) and hydrophilicity (negative GRAVY). There were several glycosylation and phosphorylation sites in the sequence, without a transmembrane domain and signal peptide. Moreover, several B-cell and MHC-binding epitopes were found in the EgP29 protein, which could be further used in multi-epitope vaccines. In conclusion, results of the present study can be a promising sign for achieving effective approaches to the preparation of a multi-epitope vaccines against echinococcosis. So, it is necessary that the effectiveness of the protein and its epitopes be evaluated in vitro and in vivo.

Sembrava un lombrico: la cisti del rafe mediano

The Authors describe the rare (and striking) case of a 4-year-old child with an infected median raphe cyst.

Simultaneous Bilateral Dentigerous Cysts at the Mandibular Notch with Ectopic Third Molars: A Case Report

Dentigerous cysts usually develop in the 2nd to 4th decades of life and contain the crown of an unerupted or impacted tooth. It is commonly observed in the mandibular third molar region. Typically, this kind oflesion presents withno symptoms, is often discovered during routine radiographic examination, and presents unilaterally. We report a case of a 59-year-old woman with bilateral radiolucent lesions located at the incisula mandibulae, containing the third molars. Histology of the specimens extracted from both sides showed findings of infected dentigerous cysts. It is an unusual case with regard to the site of the cysts as well as their simultaneity and bilaterality.

Microbiology of Facial Skin Infections—Strains, Susceptibility, and Therapeutic Consequences

Skin and soft tissue infections (SSTIs) are common conditions with severe and potentially life-threatening outcomes. However, the use of antibiotics to treat these infections is controversial. This study was to identify the microorganisms responsible for facial SSTIs, their antibiotic sensitivities, and the therapeutic outcomes of treatment. This was a retrospective, observational cohort study conducted at a single oral and maxillofacial plastic surgery department. The study sample included 103 patients with facial SSTIs (61 men, 42 women) with a mean age of 41.8years (standard deviation±20.4). The predictor variables included patient characteristics, antibiotic use before the clinic visit, and the infection's site and origin. The primary outcome variable was the presence of antibiotic resistance in the bacterial strains isolated from the infections. The data were collected by reviewing the results of microbiological swabs and patient records obtained from patients with facial SSTIs. Categorical variables were described using absolute and relative frequencies, and continuous variables were described using mean and standard deviation. The association between antibiotic resistance and the predictor variables was analyzed using Pearson's χ2 test and student's t test. The most common cause of SSTI was an infected epidermal cyst (60.1%). Of all the microorganisms identified, 80.6% were Gram-positive, and 55.8% showed antibiotic resistance against one or more of the evaluated antibiotics, including several backup antibiotics. There were no identified risk factors that significantly influenced the probability of resistance, and there were no adverse events observed. The results of this study suggest that surgery should be the primary approach for treating SSTIs, as antibiotic administration may not be effective due to the unknown susceptibility of the causative strains. Antibiotics should be reserved for severe cases and high-risk patients, and if deemed necessary for SSTI management, a broad-spectrum antibiotic should be administered to cover resistant organisms.