The clinical features and severity of DCA varied according to different age groups, perhaps due to the location of the infection and a higher incidence of comorbidity in adults. Thus, DCA in adults is more facile to have multispace involvement and lead to complications and seems to be more serious than that in children.

First described in 1768, the Pott's puffy tumor is a subperiosteal abscess associated with frontal bone osteomyelitis, resulting from trauma or frontal sinusitis. The classic clinical presentation consists of purulent rhinorrhea, fever, headache, and frontal swelling. The diagnosis is confirmed by CT scan and treatment requires intravenous antibiotics, analgesia, and surgical intervention. Early diagnosis and aggressive medical and surgical approach are essential for a good outcome. It rare and the early diagnosis is important; we describe the case of a 14-year-old adolescent with Pott's puffy tumor who was initially treated inadequately, evolving with extensive frontoparietal abscess. The patient underwent surgical treatment with endoscopic endonasal and external approaches combined. Intravenous antibiotics were prescribed for a prolonged time, with good outcome and remission of the complaints.

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Expressão de CDX2 e mucinas (MUC1, MUC2, MUC5AC e MUC6) em esôfago de Barrett antes e após fundoplicatura de Nissen Expression of CDX2 and mucins (MUC1, MUC2, MUC5AC and MUC6) in Barrett's esophagus before and after Nissen fundoplication

AbstrAct:Viral infections in the oral cavity are frequent complications in patients with immunosuppression. The herpes simplex virus is among the most frequent causes of these infections. In immunocompromised patients the presentation may be atypical, with more extensive lesions, painful and with slower recovery. The goal of this article is to present a illustrative case of herpes oral infection in an immunosuppressed patient. Case report: Female patient, 43 years old, 32 days after the start of chemotherapy for acute myeloid leukemia, began complaining of odynophagia and painful emergence of lesions in the oral cavity. She presented multiple whitish ulcerated lesions with an erythematous halo, measuring around 0.5 cm in diameter across the mouth and the posterior wall of oropharynx. Treated with acyclovir with rapid improvement of symptoms and lesions. Cytological changes were found compatible with herpes simplex. Discussion: In most cases of infection with herpes simplex the presentations are self-limited but severe infections may occur and atypical in immunosuppressed individuals. Additional exams help in diagnosis as diagnostic cytology, ELISA and direct immunofluorescence. Acyclovir is the drug of choice for the treatment recommended dose of 1 g/day for a minimum period of 10 days. Conclusion: The oral lesions of herpes virus in immunosuppressed patients may have varied presentations and can often go unnoticed, as in mild or asymptomatic cases. However, due to the possibility of systemic spread of infection and the occurrence of severe manifestations, one should be highly suspected before the appearance of any oral lesion in the immunosupressed patients.

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Introduction:The translabyrinthine approach has been increasingly used in the removal of tumors of the cerebellopontine angle. Sigmoid sinus thrombophlebitis (SST) is a possible complication of this surgical approach.Case report: Male, 69 years-old with progressive unilateral hearing loss on his left side, which started three years before, and tinnitus. Audiometry showed deafness in the left ear. MRI showed a 1.5 cm lesion in the left cerebellopontine angle. Surgical resection via translabyrinthine. Biopsy revealed vestibular schwannoma (VS). On the 15th postoperative day, he developed headache, blurred vision, dizziness, nausea and fever, no signs of meningeal irritation or other neurological deficits. The wound showed signs of inflammation. Imaging studies showed elongated filling defect extending from the transverse sinus to the sigmoid sinus on the left. He underwent intravenous antibiotic treatment, with good clinical evolution. Discussion:The SST is a rare complication in the resection of VS. Among the possible explanations of the event stand out within retraction intraoperatively; sinus dissection during resection of the tumor and the spread of infectious processes from the mastoid causing septic thrombophlebitis. On contrast-enhanced CT can find central triangular area does not enhance and is bounded by the dura mater captive contrast, also known as a sign of "empty delta". Treatment may include anticoagulation, antibiotic therapy and surgical procedures. Considerations:The incidence of SST decreased after intravenous antibiotic treatment. Diagnosis requires clinical suspicion and imaging studies.