Infected Cyst Research Articles

Treatment of supra-infected mandibular cysts using a decompression device. A case report

The golden standard treatment for odontogenic cysts of the jaws is the method of enucleation or cystectomy. Although this method is commonly used, it has some disadvantages: it is traumatic, there is a high risk of damage to adjacent anatomical structures (mandibular canal, maxillary sinus, nasal cavity) or to the vascular-nervous bundle of the teeth adjacent to the formation, and it is limited to patients with concomitant decompensated chronic pathologies. Therefore, in the case of large-sized cysts (over 3 cm), minimally invasive methods (decompression with aspiration or marsupialization) are more frequently used. Therefore, in this article, the authors described the treatment of a clinical case of a giant infected odontogenic cyst of the mandible, using for the first time a special decompression and aspiration device, individually made of acrylate. As a result, the cystic cavity decreased in volume, and the process of bone apposition contributed to the removal of the formation from the mandibular canal content, which allowed the removal of the remaining cystic membrane without damaging it, avoiding the risk of subsequent paresthesia.

Isolation of Salmonella enterica Serovar Typhi from Infected Intracranial Dermoid Cyst: A Case Report

Salmonella Typhi is a versatile pathogen that can infect almost all organs of its host. There has been an increase in the number of cases of extraintestinal infection caused by Salmonella species during the past decade. Present case is of a 17-year-old immunocompetent female admitted to the hospital with complaints of a general tonic-clonic seizure and diagnosed with a Suprasellar hypodense lesion with Hydrocephalus (HCP) documented on a Computed Tomography (CT) scan of the head. Magnetic Resonance Imaging (MRI) revealed signs of an intracranial dermoid cyst. Placement of a right Ventriculoperitoneal (VP) Shunt was performed, followed by a right craniotomy with decompression, during which 5 mL of pus was collected from the lesion. The pus was received in the Department of Microbiology and subjected to culture, which grew Salmonella enterica serovar Typhi. The patient had been empirically receiving injection cefoperazone-sulbactam 2g/2g twice daily and injection vancomycin 1g 12 hourly before the isolation of Salmonella Typhi. She had also been receiving injection levetiracetam 500 mg i.v. twice a day and inj. phenytoin 500 mg i.v. thrice a day. Following the positive culture report, injection ceftriaxone 2 g daily was started. The patient was discharged on the fifth postoperative day while on injection ceftriaxone, oral levetiracetam 500 mg, and phenytoin 100 mg and was asked to report to the neurosurgery department after seven days for follow-up. On follow-up, she showed improvement, and there were no complaints of fever, seizure, or loss of consciousness. In conclusion, proper clinical, radiological, and microbiological evaluation is very much necessary, and clinicians should be aware of the relatively rare manifestations of Salmonella Typhi infections.

Acute Abdomen Caused by Infected Mesenteric Cyst.

Teaching point: Computed tomography is essential for timely diagnosing infected mesenteric cysts as a cause of acute abdomen, ultimately requiring complete excision to confirm diagnosis given the potential of malignant transformation.

Clinical and morphological features of eccrine acrospiroma: analysis of literature data and case from practice.

Eccrine acrospiroma is a rare benign tumor of the skin arising from the epithelial cells of eccrine sweat ducts. The clinical picture is characterized by its variability, so a detailed morphological study of the operative material is necessary to establish a diagnosis. Differential diagnosis must be carried out with hemangioma, melanoma, infected sebaceous cyst, metastatic skin lesion, and other tumors from elements of the sweat gland. In the article the authors presented the clinical and morphological analysis of own case from practice of large eccrine acrospiroma on the back surface of the left thigh which was diagnosed in a 56-year-old man.

Primary cutaneous aspergillosis presenting as a cystic lesion in the foot

Aspergillosis is a fungal infection, usually affecting the lungs, mostly in immunocompromised patients. Musculoskeletal or cutaneous involvement is extremely rare and when it does occur, the diagnosis and treatment is delayed. We present a case of primary cutaneous aspergillosis presenting as a cyst in the foot of a 54-year-old immunocompetent female. She presented with the complaint of painful lump over right foot at the region of the fourth webspace. Magnetic Resonance Imaging (MRI) was suggestive of infected ganglion cyst. However, histopathological examination showed granulomas with areas of caseous necrosis and silver stain showed multiple fungal hyphae with morphology suggestive of Aspergillus species.

Presentations, diagnosis, treatment and outcome of complicated liver hydatid cysts: from an endemic area

Background: Hydatid cysts (HC) can involve all organs of the human body but most often in the liver (77% to 50%) and lungs (35%18%). (HC) is endemic in certain areas of the world as in the Middle and Far East, Iran, Australia, New Zealand, and South America. (HC) remains a considerable public health problem. Methods: In a retrospective study was carried out in north of Iran Guilan Provence. A total of 322 patients who were operated on for 382 (HC in the liver between 2016 to 2020 were evaluated. Patients were divided in tow group complicated (HC) in 87 patients and uncomplicated (HC) in 235 patients.frank intra-abdominal in 15 and frank Intrabiliary rupture in 14, occult Intrabiliary rupture in 32, cyst infection in15, intrapleural and intraparachimal rupturein 10 patients. Results: The patient’s gender included 72% were men and 28% were women with a median age of 18 to 64 years. Abdominal ultrasound, computed tomography, MRCPand ERCP were the diagnosis tools. In interapleural or intraparachymal rupture thoracotomy and laparotomy performed with evacuatin and omentoplaty, capitonnage and decortication.in trapricardial rupture thoracoyomr and pricadiotomy and laparotomy and omentoplasry, pricystectomy or capitonnage was performed There was one mortality. The postoperative morbidity was in 28 patients in complicated cysts and 12 in uncomplicated cysts. Conclusion: Complicated hydatid cyst of the liver can be successfully managed surgically with good long-term results. Complicated liver echinococcosis demonstrates several distinct features that differentiate it from the noncomplicated disease. Frequently severe clinical manifestations, complexity of surgical management, and the increased postoperative complications characterize complicated liver echinococcal disease

Infected epidermal splenic cyst. Case report

Los quistes esplénicos son infrecuentes y presentan una baja incidencia (0.07%). Las etiologías son varias, pero en su mayoría se deben a parasitarios y no parasitarios. Entre los primeros se encuentran los quistes hidatídicos por equinococosis que son más comunes sobre todo en zonas endémicas. En el siguiente trabajo se presenta el caso de una paciente de sexo femenino de 17 años de edad que consulta por un cuadro de 6 días de evolución que inicia con dolor, tipo puntada de moderada intensidad, localizado en hipocondrio izquierdo, acompañado de fiebre graduada en 38 grados con escalofríos.

An Innovative Therapy by Changing the Gut Microbiome for the Dual Post-Operative Complications of the Recurrent Methicillin-Resistant Staphylococcus aureus (MRSA) Infections in the Residual Type II First Branchial Cyst and Facial Nerve Palsy

A very unusual, interesting, and challenging case of a 24-year-old female who was born with three openings in the neck. The patient had chronic abdominal gaseous distention, recurrent abdominal pain, and constipation since early infancy. The patient presented in emergency with acute painful red, hot, and tender swelling in the left upper cervical area. Laboratory studies showed high inflammatory markers and a provisional diagnosis of abscess with a sinus was made. The patient underwent an emergency incision and drainage. Sinus recurred and a sinogram showed it to be a residual cyst in the left submandibular salivary gland. The total cyst excision was attempted with resultant recurrence and grade IV facial nerve palsy. Post-operatively recurrent infections caused by Methicillin-resistant Staphylococcus aureus (MRSA) required several courses of oral and intravenous broad-spectrum antibiotics with several hospital admissions with no resolution in sight. Subsequent ultrasound and magnetic resonance imaging showed a residual infected cyst, cutaneous sinus, and a fistula opening in the left ear canal. A diagnosis of branchial cyst type II of the first brachial cleft remnant with a fistula was established with bilateral branchial fistulas of the second branchial remnants and the associated colorectal hypoganglionosis based on radiological studies. The patient refused any further operative interventions. Therefore, the option of conservative treatment of hypoganglionosis with holobiotics consisting of prebiotics, probiotics and postbiotics, laxatives, dietary changes, lifestyle modifications, and dietary supplements started. All antibiotics were stopped. These therapies resulted in the resolution of residual first branchial remnants and recurrent MRSA infections with the improvement in the facial nerve palsy from grade IV to grade III-IV together with an excellent cosmetic and functional result. The patient is doing well at follow-ups being infection-free for 18 months and repeat contrast-enhanced computed tomogram (CECT) has shown complete resolution of the residual cyst, sinus, and fistula with fibrosis.

Toxoplasma gondii seroprevalence in reindeer (Rangifer tarandus tarandus L.) in northern Sweden: a cross-sectional study from 2014

BackgroundToxoplasma gondii is a parasitic protozoan that can infect a wide range of warm-blooded animals, including humans. The infection with T. gondii, is of particular concern due to its potential impact on human and animal health. In Sweden, semi-domesticated reindeer (Rangifer tarandus tarandus L.) is an important species both economically and culturally, but susceptibility to Toxoplasma infection and seroprevalence in reindeer herds remain relatively understudied.ResultsA total of 528 reindeer, sampled at two slaughterhouses in Sweden in 2014, were investigated for antibodies to T. gondii. Specific antibodies to T. gondii were found in 5 of 209 (2.3%) tested adult reindeer and in 6 of 308 (1.9%) tested calves, giving an apparent total prevalence of 2.1% (95% confidence interval 1.1–3.8%). None of four putative risk factors studied (sex, age, type of grazing area, county) were statistically associated with T. gondii seroprevalence.ConclusionsSwedish semi-domesticated reindeer are exposed to T. gondii and may harbour infectious tissue cysts. To mitigate the risk of T. gondii infection in consumers, reindeer meat should be frozen or cooked thoroughly before consumption. The global climate change may influence the seroprevalence and possible associated risk factors for T. gondii in reindeer. To be able to manage the risk and get better advice to the consumers there is a need for further investigations covering the whole spectra of herding conditions for reindeer.

Gut microbiota-related metabolite alpha-linolenic acid mitigates intestinal inflammation induced by oral infection with Toxoplasma gondii

BackgroundOral infection with cysts is the main transmission route of Toxoplasma gondii (T. gondii), which leads to lethal intestinal inflammation. It has been widely recognized that T. gondii infection alters the composition and metabolism of the gut microbiota, thereby affecting the progression of toxoplasmosis. However, the potential mechanisms remain unclear. In our previous study, there was a decrease in the severity of toxoplasmosis after T. gondii α-amylase (α-AMY) was knocked out. Here, we established mouse models of ME49 and Δα-amy cyst infection and then took advantage of 16S rRNA gene sequencing and metabolomics analysis to identify specific gut microbiota-related metabolites that mitigate T. gondii-induced intestinal inflammation and analyzed the underlying mechanism.ResultsThere were significant differences in the intestinal inflammation between ME49 cyst- and Δα-amy cyst-infected mice, and transferring feces from mice infected with Δα-amy cysts into antibiotic-treated mice mitigated colitis caused by T. gondii infection. 16S rRNA gene sequencing showed that the relative abundances of gut bacteria, such as Lactobacillus and Bacteroides, Bifidobacterium, [Prevotella], Paraprevotella and Macellibacteroides, were enriched in mice challenged with Δα-amy cysts. Spearman correlation analysis between gut microbiota and metabolites indicated that some fatty acids, including azelaic acid, suberic acid, alpha-linolenic acid (ALA), and citramalic acid, were highly positively correlated with the identified bacterial genera. Both oral administration of ALA and fecal microbiota transplantation (FMT) decreased the expression of pro-inflammatory cytokines and restrained the MyD88/NF-κB pathway, which mitigated colitis and ultimately improved host survival. Furthermore, transferring feces from mice treated with ALA reshaped the colonization of beneficial bacteria, such as Enterobacteriaceae, Proteobacteria, Shigella, Lactobacillus, and Enterococcus.ConclusionsThe present findings demonstrate that the host gut microbiota is closely associated with the severity of T. gondii infection. We provide the first evidence that ALA can alleviate T. gondii-induced colitis by improving the dysregulation of the host gut microbiota and suppressing the production of pro-inflammatory cytokines via the MyD88/NF-κB pathway. Our study provides new insight into the medical application of ALA for the treatment of lethal intestinal inflammation caused by Toxoplasma infection.5uvpHNDACknu2usY1bpcjuVideo

Does the expression of granzyme B participate in inflammation, fibrosis, and fertility of hydatid cysts?

Echinococcus granulosus (sensu lato), a cestode that is endemic in Egypt, causes cystic echinococcosis (CE), a significant but neglected zoonotic disease that is prevalent throughout the world. Infected hydatid cysts are classified as fertile or non-fertile based on the presence of protoscoleces; nevertheless, the mechanism of non-fertile CE cysts remains unknown. The study aimed to assess whether granzyme B (GrB) expression and CD4 + /CD8 + could be related to the induction of non-fertile CE cysts. A total of fifty-eight individuals diagnosed with visceral hydatid cysts were selected, and they were further divided according to cyst fertility into fertile and non-fertile. Immunohistochemistry for CD4, CD8, and GrB was done. According to the results, hydatid cysts are common in adults and have no gender preference. The same clinical and laboratory data were shared by patients with fertile and non-fertile cysts (p = 0.186). GrB expression was not impacted by the fibrous deposition inside the hydatid cyst wall (p = 0.85); however, GrB was significantly correlated with the inflammatory density (p = 0.005). GrB expression was also found to be significantly higher in non-fertile cysts (p = 0.04). GrB expression is positively correlated with CD4 and CD8 expression. In conclusion, the expression of GrB in hydatid cysts may exacerbate the inflammatory response and impede cyst fertility while not affecting the fibrous deposition in the cyst wall.

Risk-adjusted analysis of perioperative outcomes after the Sistrunk procedure.

Thyroglossal duct cyst (TGDC) is the most common pediatric congenital neck mass. The Sistrunk procedure is the standard method of excision and is associated with low rates of recurrence. This study aimed to review our institution's outcomes following the Sistrunk procedure, specifically the rates of wound complications and cyst recurrence. This was a retrospective case series of pediatric patients undergoing the Sistrunk procedure from June 2009 to April 2021. A total of 273 patients were included. Of these, 139 (53%) patients were male and 181 (66%) were white. The average age at the time of surgery was 7.1 years. The overall cyst recurrence rate was 11%. The most common wound complications were seroma (14%) and surgical site infections (SSIs) (12%). Wound complications were associated with prior history of cyst infection (odds ratio [OR] 1.97, 95% confidence interval [CI] 1.07-3.60, z-test 2.2, p = .03). Pediatric surgery was associated with fewer wound complications (OR 0.18; 95% CI 0.05-0.6, z-test -2.78, p = .005). However, pediatric surgery operated on fewer patients with a history of cyst infection (36% vs. 55%, p = .012). Drain placement and postoperative antibiotics did not affect rates of wound complications. Prior cyst infection is associated with increased rates of postoperative wound complications. Postoperative antibiotics and drain placement did not significantly affect complication rates. 4.

Bilateral Ureteral Ligation During Hysterectomy: A Case Report

Bilateral ureteral ligation is a complication of pelvic surgery. It can affect the functional prognosis of both kidneys and even the vital prognosis. We report the case of a 49-year-old woman, multiparous, referred from the peripheral hospital of Meknes for management of anuria in connection with a suspected ureteral lesion after hysterectomy for an infected uterine cyst. Clinically, the patient had bilateral low back pain and a fever of 38.5. On laboratory examination, she had impaired renal function and a worsening infectious work-up. The diagnosis of iatrogenic bilateral ureteral ligation was suspected. The patient underwent an initial bilateral percutaneous nephrostomy, followed by bilateral double J stent elevation after confirmation of contrast medium passage following opacification of the nephrostomies. Postoperative recovery was straightforward, with normalization of renal function and improvement in the infectious workup.

Endoscopic ultrasound‐guided infectious liver cyst drainage associated with autosomal dominant polycystic kidney disease in which percutaneous approach is impossible

AbstractA man in his 70s on maintenance dialysis for autosomal dominant polycystic kidney disease was admitted with epigastralgia and a fever lasting for 1 week. Computed tomography showed a thickened liver cyst measuring 121 mm in the caudate lobe, suggesting infection. Percutaneous drainage was impossible because multiple liver cysts and ascites entered the puncture route. Endoscopic ultrasound (EUS) revealed a huge liver cyst with debris‐like echoes. Transgastric EUS‐guided drainage was performed, and internal and external drainage was performed without adverse events. After the procedure, the symptoms quickly improved, and the external drain was removed after 12 days. The internal drainage stent remained in place, and the patient was discharged from the hospital 53 days after the EUS‐guided drainage. EUS‐guided drainage is an effective alternative treatment for infected liver cysts where a percutaneous approach is impossible.

Cholesterol Crystals in Odontogenic Cysts: An In-Depth Narrative of Pathogenesis

Cholesterol crystals (CCs) are a relatively common finding in infected odontogenic cysts occurring in about 60% of the cases. Histopathologically, these appear as longitudinal cleft-like spaces or may appear as a collection in cholesterol granulomata. The occurrence of CCs in odontogenic cysts is closely associated with the pathophysiology of the lesions. Despite being fairly common, not much is known about the sources of cholesterol, the mechanism of formation of these clefts, their pathogenesis, and their clinical implications. The present article focuses on describing CCs with respect to their contents, pathogenesis, and clinical implications. Our review describes the mechanism of the formation of CCs in a detailed manner along with a pictorial depiction of the cascade of events involved in the process. The formation of cholesterol granulomata is a cumulative effect of the breakdown of erythrocytes and leukocytes, intramural hemorrhage, decreased blood supply and lymphatic drainage, hypoxic conditions, increased vascular permeability, accumulation and rupture of lipid-laden macrophages, and foreign body reaction. It would be of great interest to pathologists to have an in-depth understanding of the pathogenesis, nature, and implications of CCs, which are very common yet enigmatic entities.

SAT197 A Rare Case Of Infected Parathyroid Cyst Associated With Hyperparathyroidism

Abstract Disclosure: B. Ataallah: None. M. Al Tameemi: None. P.R. Orlander: None. Introduction: Parathyroid cysts are considered rare lesions compromising 1-5 % of neck masses. Clinical pictures can range from asymptomatic to symptoms and signs of hyperparathyroidism, and it may lead to compressive symptoms as well. Infection of the parathyroid cyst is not reported in literature. We are presenting a patient with parathyroid cyst and was found to be infected with E-coli. Case presentation: A 59-year-old woman presented with neck swelling and ear pain. She was initially diagnosed with otitis externa and was treated with antibiotics. Her neck swelling worsens over a brief period with associated ear drainage and shortness of breath. Computed tomography (CT) scan of the neck revealed a large cystic lesion up to 10 cm in largest diameter in the region of the thyroid gland with inflammatory changes extending to the prevertebral soft tissues. CT scan of the chest showed a mass effect on the trachea and adjacent structures with possible hemorrhage. Eventually the patient was intubated. Laboratory evaluation revealed parathyroid hormone (PTH) at 455 pg/ml, corrected calcium of 11.3 mg/dl, Ionized calcium of 1.41 mMol/L, and phosphorus at 3.0 mg/dl. Aspiration of the cyst was done prior to surgery and the culture grew E-coli. She started on antibiotics, and eventually underwent a total thyroidectomy with excision of the parathyroid cyst and adenoma. Pathology showed a ruptured cyst with marked inflammation and granulation tissue with hypercellular left superior parathyroid gland. Postoperatively, corrected calcium dropped to 10.1mg/dl and PTH to 38.5 pg/ml. Discussion: Parathyroid cyst (PC) is a relatively rare neck or mediastinal lesion, representing less than 0.5% of parathyroid gland disorders. Most PCs are nonfunctional, but some may produce excess parathyroid hormone or can cause local compressive symptoms like dyspnea, dysphagia, or hoarseness of voice, depending on the size and location of the lesion. There are no distinct clinical or radiological features to differentiate parathyroid cysts, and that makes preoperative diagnosis challenging, and most cases are diagnosed during surgery or postoperatively. Aspiration and fluid analysis can confirm the diagnosis preoperatively, and the treatment can be achieved either by cyst aspiration for small lesions with less than 2.5 cm in diameter, through sclerosing agent injection, or by surgical resection. In this patient, the culture of the aspirated parathyroid cyst surprisingly grew E coli. It is unusual to have an infection with E coli in the neck tissues or the surrounding structures, and it is unknown whether the cyst infection is related to the ear infection that our patient has. Parathyroid cyst infection is not reported in literature reviews, and it is important to consider fluid analysis and culture to confirm the diagnosis preoperatively and to rule out cyst infection Presentation: Saturday, June 17, 2023

Emergency/Elective Surgery and Emergency Percutaneous Interventions in Liver Hydatid Cysts and Their Results.

Hydatid cyst may remain asymptomatic for several years or may become complicated. The aim of this study is to evaluate the patients who were operated on for liver hydatid cyst in our clinic and the results of preoperative or postoperative complications. The data of 836 patients who underwent surgery (n = 750) or Puncture, Aspiration, Injection, and Re-aspiration (n = 86) for hydatid cyst disease in our clinic between January 2006 and January 2021 were evaluated retrospectively. Surgical operation was performed in 750 of the patients and Puncture, Aspiration, Injection, and Re-aspiration procedure was performed in 89 of the patients. In the surgery and Puncture, Aspiration, Injection, and Re-aspiration group, respiratory distress, anaphylaxis, allergic rash, and urticaria were observed in 11 patients (8 in Puncture, Aspiration, Injection, and Re-aspiration group and 3 in open surgery group). All patients recovered with emergency medical interventions. Recurrence was observed after the percutaneous procedure in 11 cases and after surgery in 36 cases. There was no statistically significant difference between the surgical and Puncture, Aspiration, Injection, and Re-aspiration groups in terms of recurrence and cyst infection (P = .253 and P = .547, respectively). The incidence of the development of intrabiliary rupture, allergic reaction, and intraperitoneal rupture was found 135 (16.14%), 12 (1.43%), and 2 (0.23%) in our study, respectively. Intraperitoneal or intrabiliary rupture is a rare but fatal complication of hydatid cyst. The presence of fever, jaundice, abdominal pain, urticaria, and anaphylactic reactions in endemic areas should take the suspicion of hydatid cyst rupture. The timing of surgery is an important factor affecting morbidity and mortality. Detailed exploration of the abdomen in emergency surgery for rupture hydatid cyst is essential for recurrence.

S3776 Dire Consequences of Superimposed Infection of a Simple Hepatic Cyst

S3776 Dire Consequences of Superimposed Infection of a Simple Hepatic Cyst

Identification and characterization of an ectophosphatase activity involved in Acanthamoeba castellanii adhesion to host cells

Acanthamoeba castellanii is a free-living amoeba and an opportunistic pathogen for humans that can cause encephalitis and, more commonly, Acanthamoeba keratitis. During its life cycle, A. castellanii may present as proliferative and infective trophozoites or resistant cysts. The adhesion of trophozoites to host cells is a key first step in the pathogenesis of infection. A major virulence protein of Acanthamoeba is a mannose-binding protein (MBP) that mediates the adhesion of amoebae to cell surfaces. Ectophosphatases are ecto-enzymes that can dephosphorylate extracellular substrates and have already been described in several microorganisms. Regarding their physiological roles, there is consistent evidence that ectophosphatase activities play an important role in parasite-host interactions. In the present work, we identified and biochemically characterized the ectophosphatase activity of A. castellanii. The ectophosphatase activity is acidic, stimulated by magnesium, cobalt and nickel, and presents the following apparent kinetic parameters: Km = 2.12 ± 0.54 mM p-NPP and Vmax = 26.12 ± 2.53 nmol p-NP × h−1 × 10-6 cells. We observed that sodium orthovanadate, ammonium molybdate, sodium fluoride, and inorganic phosphate are able to inhibit ectophosphatase activity. Comparing the two stages of the A. castellanii lifecycle, ectophosphatase activity is significantly higher in trophozoites than in cysts. The ectophosphatase activity is stimulated by mannose residues and is significantly increased when trophozoites interact with LLC-MK2 cells. The inhibition of ectophosphatase by pretreatment with sodium orthovanadate also inhibits the adhesion of trophozoites to epithelial cells. These results allow us to conclude that the ectophosphatase activity of A. castellanii is somehow important for the adhesion of trophozoites to their host cells. According to our data, we believe that the activation of MBP by mannose residues triggers the stimulation of ectophosphatase activity to facilitate the adhesion process.

A case of polycystic liver with cyst infection

A case of polycystic liver infection was reported, and the diagnosis and treatment of polycystic liver infection was summarized based on its clinical features, imaging findings, and the process of diagnosis and treatment, so as to improve doctors attention to polycystic liver infection and the level of diagnosis and treatment.