Multiple cranial nerve involvement leading to diagnosis of nasopharyngeal carcinoma: case report.
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Biomedical subjects
Publications and source records attributed to A P Barrett.
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Incipient airway obstruction due to fulminating bacterial infection of pharyngeal tissues requires prompt and definitive intervention. A case is presented in which dexamethasone was a key adjunct to antibiotic therapy in averting this problem in a severely neutropenic patient with acute leukemia.
A case of type 1b glycogen storage disease (GSD) in which neutropenia and neutrophil dysfunction were prominent features is described. Oral complications included rapidly progressive periodontal disease and recurrent mucosal ulceration.
Herpes zoster virus (HZV) infection, particularly of the trigeminal nerve, can be a disabling and disfiguring condition with variable clinical presentations. Acyclovir is a highly effective treatment modality during the acute clinical phase; however, pain control may be very difficult particularly with protracted and severe post herpetic neuralgia (PHN). The clinicopathologic features are reviewed and two cases in immunosuppressed patients with HZV infection of different divisions of the trigeminal nerve are presented.
Invasive fungal infection is a potentially fatal complication in severely neutropenic patients with acute leukemia. Two cases are presented to demonstrate specific clinical signs and symptoms that should alert the clinician to the possibility of aggressive invasive candidiasis of the oropharynx.
The skills necessary to successfully perform radiological procedures in general dental practice are described and should be used as criteria when developing an effective undergraduate curriculum and as determinants of the contents of continuing education programmes. The present status of undergraduate curricula. continuing education, and postgraduate programmes as well as the recognition of the specialized nature of dento-maxillo-facial radiology, are discussed and recommendations for future developments are made.
A severely neutropenic patient, undergoing bone marrow transplantation for acute leukemia, experienced bilateral facial cellulitis accompanied by high fever and a facial folliculitis. All resolved with the addition of flucloxacillin to existing antibiotics suggesting a causal role for staphylococci.
A case is presented in which a patient performed persistent covert acts of self-mutilation through mechanical and chemical means. The lesions first involved the oral mucosa and then the skin and were misinterpreted as erythema multiforme and pyoderma gangrenosum, respectively.
A case involving a rapidly progressive neck infection in a severely neutropenic patient with acute leukemia is reported. Resolution followed the addition of metronidazole to an existing standard piperacillin/gentamicin combination, which was used primarily to cover potential gram-negative bacillary pathogens. This indicated the importance of considering extension of anaerobic cover in such infections.
Orofacial mucocutaneous infections caused by herpes simplex virus (HSV) may exhibit a distinct chronic indolent pattern of behavior in some immunosuppressed patients as opposed to the more familiar aggressive patterns. Three patients with chronic leukemia who illustrate this chronic indolent pattern are presented. These cases should alert the clinician to the variable clinical appearance that HSV may adopt in the immunosuppressed patient.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Four patients with multiple myeloma refractory to conventional chemotherapy received high-dose melphalan. All experienced multiple oral complications. Extensive neutropenic ulceration and orofacial herpes simplex virus infection caused considerable morbidity in three patients during prolonged periods of neutropenia.
Oral complications were detected during 89% of hospital admissions for treatment of acute leukemia in adults. Changes that reflected the underlying myelosuppression and general immunosuppression predominated. Hemorrhagic phenomena (77%), neutropenic ulceration (49%), and herpes simplex virus infections (39%) were the most common.
The clinical characteristics of chemotherapy-induced oral mucosal ulceration in a group of patients with acute leukemia were examined in detail in a long-term prospective clinical study. Differences in regional susceptibility within the mouth to the effects of chemotherapy were apparent. A reconstruction of the probable mechanisms involved is presented.
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