Yellow Exudate Research Articles

The marks of leprosy: disabilities caused by plantar lesions in discharged patients.

Leprosy is a chronic infectious disease that has a slow evolution and is characterized by dermatoneurological involvement. The health challenges surrounding this disease are closely related to the stigma that results from the physical disabilities it causes. This is due to its high rate of late diagnosis and the peculiar deformities that occur in its advanced stage.Evaluate the clinical and epidemiological aspects of patients with plantar lesions who were treated for leprosy in a dermatology referral unit.This is a cross-sectional exploratory field study that was conducted at the Reference Center in Tropical Dermatology and Venereology Alfredo da Matta (FUHAM), in Manaus, Amazonas, Brazil.We evaluated 36 patients with disabilities as a result of leprosy and who had plantar lesions. The most common ulcer site was the medial region of the plantar surface, which presented dryness and maceration with yellowish seropurulent exudate, fibrinous tissue and grade 2 depth.The study made it possible to observe the evolution of plantar ulcers resulting from the disease process, then evaluate them and discuss recommendations regarding the treatment and prevention of this type of physical disability.

Efficacy of Entomopathogenic Staphylococcus Bacteria as a Biocontrol Agent against Rhipicephalus microplus Ticks: Assessing Reproductive Inhibition and Mortality Rates.

Rhipicephalus microplus is a persistent ectoparasite of cattle that causes bovine anaplasmosis and babesiosis, causing economic losses worldwide. Chemical treatment is the primary method for tick control, but the emergence of pesticide-resistant ticks is a major challenge. Alternative biocontrol strategies utilizing entomopathogenic microorganisms are being explored. This study aimed to validate the species identification and assess the efficacy of four strains of Staphylococcus bacteria (S. shinii S1 and S-2, S. succinus, and S. xylosus) previously reported as being entomopathogenic to R. microplus ticks. According to the bioassays, S. shinii S-1 exhibited the greatest degree of reproductive inhibition (47%), followed by S. succinus (44.3%) at a concentration of 1 × 108 cfu/mL. S. xylosus displayed decreased reproductive inhibition (6.3%). In an additional bioassay, S. shinii S-1 exhibited a significant larval mortality of 67.63%, followed by S. succinus with 66.75%, S. shinni S-2 with 64.61%, and S. xylosus with 28.18% mortality. The common signs of infection observed on these ticks included swelling, yellowish exudate on the hypostome, and reduced limb mobility and color change, except for S. succinus, which did not cause color changes. These bacteria were naturally found on bovine skin. However, further studies are needed to confirm their potential as promising alternatives or complementary agents to existing acaricidal compounds.

Differential diagnosis of red scalp: the importance oftrichoscopy.

Red scalp is a common complaint that may constitute a diagnostic and therapeutic challenge in daily clinical practice. Among the numerous diseases to cause diffuse scalp erythema are psoriasis, seborrhoeic dermatitis, contact dermatitis, diffuse lichen planopilaris, dermatomyositis and scalp rosacea. Accurate diagnosis is crucial for optimal treatment outcomes. Histology most frequently discriminates the underlying condition, but it requires scalp biopsy. In many cases, the combination of clinical examination and trichoscopy is sufficient for establishing the correct diagnosis. The main trichoscopic features of psoriasis are silver-white scaling, regularly distributed dotted (glomerular) vessels or twisted red loops, and punctate haemorrhages. Yellowish-white scaling and thin arborizing vessels are typical features of seborrhoeic dermatitis. Contact dermatitis is characterized by the presence of yellow exudate and polymorphic vessels, while perifollicular scaling and erythema with the lack of follicular openings are typical findings in lichen planopilaris. In scalp dermatomyositis, tortuous and arborizing vessels with interfollicular and perifollicular pigmentation may be detected. The most characteristic features of scalp rosacea are perifollicular scaling and polygonal/arborizing vessels. This review also summarizes histological features and therapeutic options for these conditions.

Supplementation with Ashitaba (Angelica keiskei) Yellow Stem Exudate Prevents Aging-Induced Thrombotic Tendencies and Systemic Inflammation Without Affecting Body Weight Gain in Mice.

Angelica keiskei Koidzumi (Ashitaba) is a traditional folk medicine and health supplement in Japan. Ashitaba yellow stem exudate (AYE) contains abundant chalcones and thus has the potential to treat and prevent many pathological states such as cancer, inflammation, obesity, diabetics, thrombosis, and hypertension. Levels of plasminogen activator inhibitor 1 (PAI-1), a key regulator of the fibrinolytic system, increase with age in mouse plasma. Therefore, we aimed to determine the effects of AYE on plasma thrombotic parameters in aging mice. Long-term (52 weeks) AYE supplementation significantly decreased age-induced increases of PAI-1 in mouse plasma. Supplementation with AYE decreased levels of the acute-phase and fibrinolytic protein plasma plasminogen, and significantly decreased those of tumor necrosis factor α. These results suggested that continuous intake of AYE throughout life decreases age-induced systemic inflammation and prevents thrombotic tendencies without affecting body weight gain in aged mice. Our findings showed that supplementing diets with AYE might help to prevent thrombotic diseases in elderly individuals.

On-Chip Discovery of Allergens from the Exudate of Large Yellow Croaker (Larimichthys Crocea) Muscle Food by Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry.

It is extremely crucial to establish facile, accurate, and fast methods for testing allergenic proteins (allergens) in seafood. The current study focuses on the evaluation of fish muscle exudate proteins in an effort to discover potential allergens in fish exudate for allergy tests. Large yellow croaker (Larimichthys crocea) was studied as a seafood model. Magnetic beads (MBs) modified with an IgE antibody were utilized to isolate allergens existing in the exudate sample. Immunoglobulin E (IgE) in blood is a class of antibodies that is mainly associated with allergic reactions. Potential allergens in the muscle exudate were fished by IgE-biofunctional MBs in microfluidic channels. The protein-attached MBs were isolated under a magnetic field, eluted, and collected. The collected eluent was digested and analyzed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry to identify allergens. Eight allergens from large yellow croaker exudate were identified, i.e., parvalbumin beta, parvalbumin, protein S100, histone H4, cytochrome c, fatty acid binding protein 3 (FABP3), microsomal glutamate S-transfer 3 (MGST3), and C-C motif chemokine 21 (CCL21). The presently proposed microfluidic-magnetic-based allergen extraction protocol enables a facile and rapid test of potentials of seafood allergies, providing a solution to circumvent food safety issues, especially for allergic populations.

Diffuse panniculitis in a teenage male with ZZ α1-antitrypsin deficiency.

Diffuse panniculitis is a rare manifestation of α1-ATD, albeit perhaps the most fulminant and life-threatening complication, associated usually with ZZ phenotype. Intravenous α1-AT treatment is lifesaving. https://bit.ly/3EDmCzT.

A study on dislipidemic and hyper glycemic activities of Aloe vera

Aloe, a popular plant, has a long history as a versatile folk remedy. The plant can be alienated mainly into two products: gel and latex. Aloe vera gel is the leaf pulp or mucilage, aloe latex, commonly referred to as “aloe juice,” is a bitter yellow exudate from the pericyclic tubules just underneath the external skin of the leaves. Extracts of aloe gum efficiently improves glucose tolerance in diabetic rats as well as in normal rats. Treatment of long term however not solitary dose of exudates of Aloe barbadensis leaves impart hypoglycemia in alloxanized diabetic rats. Solitary as well as long term doses of acrimonious component of the same plant also displayed hypoglycemic effect in diabetic rats. This response of Aloe vera and its acrimonious component is by the stimulus of synthesis and/or release of insulin from pancreatic beta cells. Aloe vera also have got the anti-inflammatory potential in a dose reliant way and relieves wound in diabetic mice by healing activity. The current article highlights the biological activities of Aloe Vera.

Early Detection of Diabetic Retinopathy Using Various Techniques: A Review

Diabetic retinopathy is a complication of diabetes, caused by high blood sugar levels damaging the back of the eye (retina). It can cause blindness if left undiagnosed and untreated. However, it usually takes several years for diabetic retinopathy to reach a stage where it could threaten your sight. Diabetic retinopathy is caused by damage to the blood vessels in the tissue at the back of the eye (retina). Poorly controlled blood sugar is a risk factor. Early symptoms include floaters, blurriness, dark areas of vision and difficulty perceiving colors. Blindness can occur. Mild cases may be treated with careful diabetes management. Advanced cases may require laser treatment or surgery. DR is characterized by lesions on the retina and this paper focuses on detecting two of these lesions, Microaneurysms and Haemorrhages, which are also known as red lesions. Microaneurysms are usually the earliest visible manifestation of diabetic retinopathy. They appear as tiny red dots scattered in the retina posteriorly. They may be surrounded by a ring of yellow lipid, or hard, exudates or diabetic retinopathy that is threatening or affecting your sight, the main treatments are: Laser Treatment – to treat the growth of new blood vessels at the back of the eye (retina) in cases of proliferative diabetic retinopathy.

Recent Advances in RPE Adenoma

Abstract Adenoma and adenocarcinoma, are two uncommon acquired true neoplasms of the RPE. They highly mimic uveal melanomas which carry high risk of metastasis so it is critical to recognize RPE tumors and distinguish them from melanomas. The majority of RPE neoplasms present as a dome shaped elevated darkly pigmented lesion. The presence of exudative retinal detachment, yellow intraretinal exudation around the mass as well as the presence of a feeding artery and a draining vein are among the distinguishing features from uveal melanomas. Acquired RPE neoplasms are usually peripheral however, peripapillary RPE neoplasms has been reported. Among the management options for the small sized RPE tumors below 4 mm in thickness are cryotherapy or transpupillary thermotherapy. For larger tumors; PDT, partial lamellar sclerouvectomy or external beam irradiation were recommended. Recently, Episcleral Brachytherapy has been addressed to be an effective primary management plan with minimal long term complications in cases of RPE adenoma.

Postvaccinal pyogranulomas in cattle

Clinical History: The carcasses of seven 30-month-old female cows slaughtered in a local abattoir for meat production were totally condemned during meat inspection due to disseminated gross abnormalities. Gross Findings: On internal examination, several skeletal muscles (pectoralis superficialis and profundus, transversus abdominis, diaphragm, obliquus internus abdominis, and rectus abdominis) and random areas of the peritoneal cavity had multifocal to coalescing nodules (1-3 cm in diameter). The nodules were firmly adhered (fibrous adherences) to the adjacent tissues and surface of portions of the forestomach serosa and splenic capsule. On the cut surface of the nodules, there was a central accumulation of a friable and yellow exudate surrounded by a fibrous capsule. No external lesions were seen in any of the cows.

Effects and mechanism of water-soluble chitosan hydrogel on infected full-thickness skin defect wounds in diabetic mice

Effects and mechanism of water-soluble chitosan hydrogel on infected full-thickness skin defect wounds in diabetic mice

Thoracic spinal epidural empyema in a cat

A 2-month-old male domestic shorthair cat was referred to a private veterinary clinic with a history of dyspnea and inappetence. At the clinical examination, the cat was in poor body condition, with hyperthermia and abdominal distension. No major abnormalities were observed in the thoracic radiographs or abdominal ultrasound. A complete blood count revealed leukocytosis with neutrophilia. Although no clinical diagnosis was made, the cat received support therapy, but went into cardiac arrest and died. The cat was submitted for necropsy and the main gross finding was two white nodules on the ventral surface of the thoracic vertebrae (from T1 to T4). At the cut surface, the nodules were friable and filled with yellow exudate. The epidural space of the thoracic region was filled with yellowish viscous material. Histologically, the vertebrae were partially replaced by abscess formation characterized by a necrotic center with degenerate neutrophils, surrounded by fibrous connective tissue. The epidural space was filled with degenerate neutrophils, necrotic debris, fibrin, and intralesional colonies of gram-negative short rod-shaped to coccobacillary bacteria. Bacteriologic culture yielded Pasteurella multocida. This paper describes the gross, histological, and bacteriological features of a rare case of spinal epidural empyema caused by Pasteurella multocida in a cat.

First Report of Dragon Fruit (Hylocereus undatus) Stem Rot Caused by Diaporthe ueckerae in Taiwan.

Dragon fruit (Hylocereus polyrhizus & H. undatus) is a rapidly growing commodity in Taiwan. The production acreage has been tripled since 2011, with an estimation of over 2,800 ha in 2019. From disease survey conducted in July 2020, reddish orange to blackish brown lesions similar to stem canker caused by Neoscytalidium dimidiatum on dragon fruit cladodes (Supplementary Fig. S1, Q) were observed from two orchards in Central Taiwan. Diseased cladodes were brought back to the lab, surface disinfested with 70% ethanol for 15 to 30 sec, and then blotted dried with a paper towel. Small pieces (about 3x3 mm) of necrotic spots were excised, placed on 2% water agar (WA) plates, and incubated with 12 h photoperiod at 28 ± 2 ℃ for 3 days. Among the necrotic spots that were used for fungal isolation, some were detected to have N. dimidiatum accounting for 21 isolates, while three isolates detected in other spots were unknown. Single hyphal tips of the three unknown fungal colonies with similar morphology were transferred on potato dextrose agar (PDA). Brownish- to grayish-white colonies with fluffy aerial mycelium were observed on PDA (Supplementary Fig. S1, A, B, E, F, I and J) after 8 days of incubation. To induce the sporulation, all the fungal isolates were cultivated on autoclaved cowpea pods on 2% WA plates with 12 h photoperiod at 25 ± 2 ℃ for 3 weeks. Black pycnidia embedded in cowpea tissues and creamy yellowish exudates with pycnidiospores extruding from the ostiole were observed (Supplementary Fig. S1, C, G and K). Alpha-conidia were characterized as aseptate, hyaline, smooth, ellipsoidal or fusiform, often bi-guttulate and measured about 6.0 to 6.5 μm × 2.0 to 2.3 μm (n = 50 for each isolate) (Supplementary Fig. S1, D, H and L). Beta-conidia were not observed. Morphological characteristics of these isolates were similar to Diaporthe spp. described by Udayanga et al. (2015). To further identify the fungal isolates, the internal transcribed spacer (ITS), β-tubulin (TUB) and translation elongation factor 1-α (EF1-α) regions were amplified using primer pairs ITS1/ITS4 (White et al. 1990), Bt2a/Bt2b (Glass & Donaldson 1995) and EF1-728F/EF1-986R (Carbone & Kohn 1999), respectively. BLAST analysis of isolates CH0720-010 (ITS: OK067377; TUB: OK149767; EF1-α: OK149764), CH0720-013 (ITS: OK067378; TUB: OK149768; EF1-α: OK149765) and TC0720-016 (ITS: OK067379; TUB: OK149769; EF1-α: OK149766) showed 99.78 to 100% of ITS identity, 98.8 to 99.2% of TUB identity, and 100% of EF1-α identity with Diaporthe ueckerae (ITS: KY565426; TUB: KY569384; EF1-α: KY569388). Phylogenetic trees were constructed using concatenated ITS, TUB, and EF1-α sequences based on maximum likelihood with HKY+G model, maximum parsimony, and Bayesian inference method in MEGA X and Geneious Prime 2020.2.4. All isolates were clustered in D. ueckerae with similar topology based on aforementioned methods, hence the phylogram of maximum likelihood was presented (Supplementary Fig. S2). To confirm the pathogenicity, detached dragon fruit (H. polyrhizus and H. undatus) cladodes (20 to 30 cm in length) were surface disinfested, wounded with sterilized syringe (about 2 mm in depth), and inoculated with mycelial plugs (6 mm in diam.) from 5-day-old colonies on PDA. Each isolate had three mycelial plugs and the PDA plugs without mycelium were inoculated as negative control. Inoculated cladodes were placed in a moisture chamber and incubated at 30 ± 2 ℃ with 12 h photoperiod. Two days after inoculation (DAI), the agar plugs were removed and symptom development on the cladodes was photo recorded every other day. The inoculation experiment was repeated twice. At 6 DAI, round to irregular, dark-brown, and water-soaking lesions were observed on the cladodes of both species inoculated with the three D. ueckerae isolates whereas all negative controls remained asymptomatic (Supplementary Fig. S1, M-P). Morphologically identical fungi were re-isolated from inoculated cladodes, fulfilling Koch's postulates. Several Diaporthe species have been reported infecting dragon fruit in the southeastern Asian countries such as Thailand, Bangladesh and Malaysia (Udayanga et al. 2012; Karim et al. 2019; Huda-Shakirah et al. 2021). To our knowledge, this is the first report of stem rot caused by D. ueckerae in Taiwan. Since the field symptoms may be easily confused with those caused by N. dimidiatum, the potential threat of Diaporthe species complex on dragon fruit should be aware and may warrant further study.

Angelica keiskei (Ashitaba) has potential as an antithrombotic health food

Angelica keiskei (Ashitaba) is a large perennial herb that is native to the Pacific coast of Japan. It has recently become popular as a healthy food in Asian countries because it might have various physiological benefits including antithrombotic properties. Most studies of the bioactive constituents from Ashitaba have focused on the activities of the major chalcones, xanthoangelol and 4-hydroxyderricin. However, other chalcones, flavanones and coumarins have also been isolated from Ashitaba, precisely characterized, and investigated in vivo. Platelets play a key role in haemostasis and wound healing processes. Dysregulated platelet activity is associated with the progression of platelet aggregation and decreased venous blood flow, which results in thrombotic diseases. A minor chalcone, xanthoangelol E, inhibits TXB2 synthesis in rabbit platelets, which seems to be the source of the belief that Ashitaba has antithrombotic properties. However, recent data showed that xanthoangelol and 4-hydroxyderricin inhibited the aggregation of rabbit platelets. Platelet aggregation stimulated by collagen was also inhibited in whole blood incubated with Xanthoangelol or 4-hydroxyderricin. Plasminogen activator inhibitor-1 is the primary physiological inhibitor of tissue type plasminogen activator, a key protease of the fibrinolytic system. An increase in plasma of this inhibitor is associated with thrombotic conditions. Ashitaba yellow exudate inhibited the elevation of plasma plasminogen activator inhibitor-1 in mice induced by obesity or chronic low-grade inflammation. These studies showed the yellow exudate from stem cuttings and chalcones isolated from Ashitaba roots and leaves might have antithrombotic activity. This article reviews the possible antithrombotic properties of Ashitaba.

Genetic structure of Eurasian beaver in Romania: insights after two decades from the reintroduction

Once exploited for fur, meat, and extracting the yellowish exudate called castoreum, the Eurasian beaver disappeared from Romania during the eighteenth century. After, the reintroductions carried out two decades ago are currently thriving in the Danube River basin. Using nine nSSR markers, we analysed samples from 98 individuals, and we found no genetic substructure, suggesting high dispersal and gene flow capabilities. The stepwise mutation model (SMM) indicated the existence of a recent genetic bottleneck, though the Eurasian beaver retains high levels of genetic diversity and population growth facilitated variation in nSSR loci. A fine-scale spatial correlation in females was detected, contrasting with males’ dispersal on longer distances. While the movement and establishment of individuals’ new territories were made under natural predation pressure, the mix following natural expansion improved the fitness and could contribute to a higher genetic diversity than the source population. With any reintroduction, a focus on capturing individuals from various geographic origins, as well as securing many and suitable founding individuals (adults, subadults, and juveniles) with mixed origins, could secure the post-genetic bottleneck recovery and higher genetic diversity. Beyond this conservation success, future management strategies should consider building a National Action Plan (NAP) for the species, including a permanent genetic monitoring programme for Eurasian beaver.

Chancroid Coexisting with Vaginal Candidiasis: A Case Report

BACKGROUND: Chancroid is a sexually transmitted disease caused by the Gram-negative bacteria, Haemophilus ducreyi. In endemic areas, the ratio of men to women is 3:1. Clinical symptoms of chancroid manifest as genital ulcers which are generally painful and tender with irregular edges. The base of the ulcer can be covered with yellow or gray necrotic purulent exudate, and often bleeds when rubbed. Vaginitis is an inflammation of the vagina and can be accompanied with symptoms such as vaginal discharge, complaints of itching, and pain. The most common cause is an imbalance of bacteria or normal flora in the vagina. CASE REPORT: We report a case of chancroid in a 20-year-old woman in conjunction with vaginal candidiasis that was later identified as Candida glabrata. The patient was then treated with a combination of oral antibiotics and antifungals, as well as normal saline dressing that then showed significant clinical improvements. CONCLUSION: Chancroid is a sexually transmitted disease that is still prevalent especially in developing countries. Diagnosis of the disease is often made clinically and should be promptly treated to prevent further complications. Coexistence of chancroid with vaginal candidiasis is rare, and combination of antibiotics and antifungals, as well as normal saline dressing proved to be effective in treating the condition.

Characteristics of endoscopic and pathological findings of amebic colitis

BackgroundThe clinical features of amoebic colitis resemble those of inflammatory bowel disease (IBD), and therefore the risk of misdiagnosis is very high. The aim of this study was to analyse the characteristics of the endoscopic and pathological findings of amebic colitis and the lessons from our patients, which were useful for diagnosing the amebic colitis timely and avoiding the serious complication.MethodsWe retrospectively reviewed data of all amebic colitis admitted to Beijing Friendship Hospital from January 2015 to January 2020. Cases were diagnosed by clinical presentation, laboratory examinations, and colonoscopy with biopsy and histological examination, no ELISA stool antigen or PCR tests were used.Results16 patients were diagnosed with amebic colitis by the colonoscopy accompanied by biopsy and microscopic examination. At first time, 12 (75%) patients were misdiagnosed as IBD. Cecum was the most common site of amebic colitis (100%), and the caecum and rectum were also involved in many lesions (68.75%). Multiple lesions of erosion and/or ulcer were recognized in all patients (100%).The endoscopic findings included multiple irregular shaped ulcers and erosions with surrounding erythema, and the ulcers and erosions were covered by the white or yellow exudates. The intervening mucosae between the ulcers or erosions were normal. The features of rectums can be divided to 2 types: in 6 patients (54.5%), the irregular ulcer or erosions covered with white or yellow exudates were observed in rectum and cecum, and the bloody exudates in rectum were more severe than those in cecum; in other 5 patients (45.5%), rectal lesions were much less severe than those in cecum, the small superficial erosion or reddened mucosa were observed in the rectal ampulla. All patients were diagnosed as detection of amebic trophozoites from HE-stained biopsy specimens. The number of trophozoites ranged from 1/HPF to > 50/HPF. Among 16 cases, mild architectural alteration of colon crypt were observed in 10 cases (62.5%), and serious architectural alteration of colon crypt was found which had crypt branch in 1 case (16.7%). Cryptitis was observed in 12 cases (75%) and its severity was mild or moderate. No crypts abscess was observed in all cases.ConclusionsThe colonoscopy with histological examination are very important to diagnose the amebic colitis. Detect the amoebic trophozoites in the exudates by histological examination is the vital. Sometimes a negative biopsy does not rule out amebiasis, repeated biopsies may be needed to make the diagnosis.

S3196 Diagnosis and Management of Phlegmonous Gastritis in a Young Female Without Predisposing Risk Factors

Introduction: Phlegmonous gastritis (PG) is a rare, but serious, condition characterized by bacterial infection of the gastric wall. Since 1862, less than 500 cases of PG have been reported in the literature, limiting knowledge of its management. We discuss a case of PG in a previously healthy female who was successfully treated with a combination of medical and surgical therapies. Case Description/Methods: A 32-year-old female presented to the emergency department with 10 days of worsening epigastric pain, fever, chills, and nausea. Symptoms onset after consuming a seafood platter containing shrimp, scallops, crab, and crawfish from a local restaurant. She had no significant past medical history. CT demonstrated heterogeneously enhancing wall thickening of the distal stomach and the first portion of the duodenum with adjacent fat stranding. Lab work was significant for leukocytosis and elevated CRP. Following admission, the patient was empirically started on piperacillin-tazobactam with general surgery and gastroenterology consulted. On hospital day 2, an EGD was performed which showed a raised lesion in the antrum with central ulceration and an overlying yellow exudate. Biopsies of the lesion were consistent with active gastritis with cryptitis. No organisms, including H pylori, were visualized on routine stains. MRI revealed a 7.5 x 4.3 cm mass in the gastric antrum with central necrosis and multiple septations. EGD with EUS on hospital day 6 noted a mass in the antrum arising from the muscular layer with areas of necrosis. FNA was performed, showing gastric columnar cells, smooth muscle fragments, and a cluster of bland-appearing spindle cells. The following day, she underwent an open distal gastrectomy with Billroth I reconstruction. Significant adhesions and a desmoid reaction involving the distal stomach to the falciform ligament was present. Tissue pathology showed a perforated ulcer with perigastric abscess and acute serositis. No malignant cells were identified. The post-operative course was uncomplicated, and the patient was discharged home on hospital day 11. Discussion: This case highlights the need to consider PG in the differential diagnosis of persistent abdominal pain, although patients may lack classic risk factors for this condition, such as immunosuppression or recent intervention. Discussion should be prompted regarding the optimal treatment regimen for PG, as there are currently no guidelines regarding standardized therapy.Figure 1.: Fig 1A: An abdominal X-ray showing the faint outline of the trichobezoar impacted within the stomach and leading to the convoluted small intestinal tract. Fig 1B: An abdominal CT scan showing the trichobezoar compacted within the stomach and the small intestines. Fig 1C: Post-operative picture of the removed trichobezoar that shows it took on the form of the stomach shape along with the tapered, elongated end of the form of the small intestine.

Post COVID-19 invasive mucormycosis and actinomycosis co-infection: a case report

<p>Actinomyces are commensals of human oropharynx and actinomycosis is considered mainly as an endogenous infection that is triggered by a mucosal lesion. Typically, the disease presents as a slowly progressive painless indurated mass evolving into multiple abscesses with draining sinus tracts sometimes expressing a typical yellow exudate with characteristic sulfur granules. The gold standard of diagnosis is histological examination and bacterial culture of the tissue. Most isolates are susceptible to beta lactams and they are the treatment of choice along with surgical management with drainage of abscesses and excision of recalcitrant fibrotic lesions and debridement of necrotic bone tissue. Here we present a case of 37-year-old male patient who has developed severe COVID-19 infection following which he developed invasive mucormycosis followed by actinomycosis. We postulate that the lymphopenia and the use of immunosuppressants used in treatment of COVID-19 lead to mucormycosis and aggressive debridement used as a strategy in treatment of mucormycosis led to colonization of actinomyces leading to cervicofacial actinomycosis.</p>

Clinical Pathologic Conference Case 1: An ulcerated nodular mass on the right hard palate

A 30-year-old Hispanic male presented to an oral surgeon with a 2.5 cm × 1 cm ulcerated nodular mass on the right lateral hard palate (Figure 1). The mass extended from the lateral palatal margin to the midline and antero-posteriorly from the rugae to the distal aspect of tooth #2. The surface was ulcerated and covered by a yellow fibrinous exudate focally with a violaceous erythematous pigmentation in other areas. The mass had raised borders and was painful and tender to palpation. As per the patient, the mass was present for a month, and he thought he had burnt the roof of his mouth after consumption of pizza.