A case of cellulitis of the left lateral side of the face caused by the zygomycete Apophysomyces elegans in a healthy male following a road trafÞ c accident is reported. The contaminated soil was the source of fungus. Broad aseptate fungal hyphae were seen in the necrosed tissues. Extensive tissue debridement and treatment with amphotericin B were not successful in controlling the rapid invasion of the tissues by the fungus. Patient developed angioinvasion, severe cellulitis and Þ nally succumbed to the infection three weeks after admission.
The most common modality of treatment for completely edentulous patients are conventional removable complete dentures. The protocol for fabrication of complete denture would involve a thorough clinical examination and radiographic investigation. As a routine, unless clinical findings suggest presence of remnant tooth structures, or the patient presents himself with symptoms, the radiographic investigations are overlooked. This case report presents one such situation wherein routine radiographic evaluation of a clinically asymptomatic edentulous individual prior to prosthetic rehabilitation revealed the presence of an odontogenic keratocyst of anterior maxilla substantiating the importance of such routine pre-prosthetic radiographic investigations.
A young man with bronchial asthma and an abnormal chest X-ray A S Kashyap, S Kashyap A 29-year-old man with bronchial asthma of 5 years duration was using inhaled salbutamol. In view of recurrent exacerbations, he had been put on oral prednisolone 20 mg/day for the last year. He did not smoke tobacco or drink alcohol. He had no other complaints. Clinically he had moon facies, buValo hump, centripetal obesity, purple striae on flanks and proximal myopathy. His blood pressure was 140/100 mmHg. Chest examination revealed polyphonic rhonchi in all areas. The rest of the general and physical examination was normal. Investigations revealed a normal haemogram, urinalysis, fasting and post-prandial plasma glucose, serum sodium, potassium, calcium and phosphate levels. Pulmonary function test showed an obstructive pattern. His chest X-ray (postero-anterior) is shown in figure 1. Chest X-ray a year earlier had been normal. Serum cortisol levels were 130 nmol/l at 08.00 h (normal 140-690 nmol/l) and 76 nmol/l at 16.00 h (80-330 nmol/l). Urine 24-hour calcium was 3.2 mmol (< 3.8 mmol).
Questions1 What are the abnormalities seen on the chest X-ray? 2 What is the pathophysiology of these abnormalities ?Figure Chest X-ray (postero-anterior)Postgrad Med J 2000;76:41-60
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