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Cytological approach for diagnosis of non-healing oroantral fistula associated with candidiasis.

Jadhav KB, Mujib BA, Gupta N - J Cytol (2014)

Bottom Line: However patient did not respond to any treatment approach and later presented with a more progressive lesion involving maxillary sinus.Finally, case was diagnosed as OAF with a superadded candidal infection.Patient responded well to antifungal treatment followed by reclosure of OAF.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral Pathology and Microbiology, Rural Dental College and Hospital, PIMS University, Loni, Maharashtra, India.

ABSTRACT
Oroantral fistula (OAF) and oral candidiasis are common to come across as separate individual lesions. However when candida organisms infect maxillary sinus through OAF then diagnosis should not be limited to clinical diagnosis only. In such situation role of cytological examination can prove to be fruitful. A female with chronic long standing OAF, not responding to conventional treatment approach is reported. On incisional biopsy, the case was diagnosed as chronic maxillary sinusitis with OAF. However patient did not respond to any treatment approach and later presented with a more progressive lesion involving maxillary sinus. A cytosmear stained with periodic acid Schiff stain, revealed the presence of numerous candidal hyphae. Finally, case was diagnosed as OAF with a superadded candidal infection. Patient responded well to antifungal treatment followed by reclosure of OAF. We should not neglect a simple cytological examination which may prevent wrong diagnosis and wrong treatment.

No MeSH data available.


Related in: MedlinePlus

(a) A 34-year-old female patient presenting with mild to moderate swelling in left maxillary sinus area (arrow). (b) Intraoral examination revealed the oroantral communication (arrow) in maxillary left anterior labial vestibule at mucogingival junction in the area of canine. (c) The dorsal surface of tongue was coated with white leathery coat with central rhomboidal shaped erythematous area (arrow). (d) The cytosmear revealed PAS positive numerous long thin filaments of candidal organism (arrow). Budding yeast cells were seen scattered along the with pseudohyphae (PAS, ×200)
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Figure 1: (a) A 34-year-old female patient presenting with mild to moderate swelling in left maxillary sinus area (arrow). (b) Intraoral examination revealed the oroantral communication (arrow) in maxillary left anterior labial vestibule at mucogingival junction in the area of canine. (c) The dorsal surface of tongue was coated with white leathery coat with central rhomboidal shaped erythematous area (arrow). (d) The cytosmear revealed PAS positive numerous long thin filaments of candidal organism (arrow). Budding yeast cells were seen scattered along the with pseudohyphae (PAS, ×200)

Mentions: The case we present here is a 34-year-old female patient [Figure 1a] who was complaining about non-healing opening in the upper left front region and exposure of root of one tooth. The lesion started as a small swelling in the left maxillary anterior vestibular area in the region of canine eminence. The swelling ruptured and exuded the discharge. After few days, patient noticed the area where the swelling ruptured was not healing and instead, it was showing small aperture. The aperture went on increasing to the present size of 0.5 cm × 0.5 cm. Patient revealed the history of trauma in maxillary left front teeth region during field work 2 years back.


Cytological approach for diagnosis of non-healing oroantral fistula associated with candidiasis.

Jadhav KB, Mujib BA, Gupta N - J Cytol (2014)

(a) A 34-year-old female patient presenting with mild to moderate swelling in left maxillary sinus area (arrow). (b) Intraoral examination revealed the oroantral communication (arrow) in maxillary left anterior labial vestibule at mucogingival junction in the area of canine. (c) The dorsal surface of tongue was coated with white leathery coat with central rhomboidal shaped erythematous area (arrow). (d) The cytosmear revealed PAS positive numerous long thin filaments of candidal organism (arrow). Budding yeast cells were seen scattered along the with pseudohyphae (PAS, ×200)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4150343&req=5

Figure 1: (a) A 34-year-old female patient presenting with mild to moderate swelling in left maxillary sinus area (arrow). (b) Intraoral examination revealed the oroantral communication (arrow) in maxillary left anterior labial vestibule at mucogingival junction in the area of canine. (c) The dorsal surface of tongue was coated with white leathery coat with central rhomboidal shaped erythematous area (arrow). (d) The cytosmear revealed PAS positive numerous long thin filaments of candidal organism (arrow). Budding yeast cells were seen scattered along the with pseudohyphae (PAS, ×200)
Mentions: The case we present here is a 34-year-old female patient [Figure 1a] who was complaining about non-healing opening in the upper left front region and exposure of root of one tooth. The lesion started as a small swelling in the left maxillary anterior vestibular area in the region of canine eminence. The swelling ruptured and exuded the discharge. After few days, patient noticed the area where the swelling ruptured was not healing and instead, it was showing small aperture. The aperture went on increasing to the present size of 0.5 cm × 0.5 cm. Patient revealed the history of trauma in maxillary left front teeth region during field work 2 years back.

Bottom Line: However patient did not respond to any treatment approach and later presented with a more progressive lesion involving maxillary sinus.Finally, case was diagnosed as OAF with a superadded candidal infection.Patient responded well to antifungal treatment followed by reclosure of OAF.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral Pathology and Microbiology, Rural Dental College and Hospital, PIMS University, Loni, Maharashtra, India.

ABSTRACT
Oroantral fistula (OAF) and oral candidiasis are common to come across as separate individual lesions. However when candida organisms infect maxillary sinus through OAF then diagnosis should not be limited to clinical diagnosis only. In such situation role of cytological examination can prove to be fruitful. A female with chronic long standing OAF, not responding to conventional treatment approach is reported. On incisional biopsy, the case was diagnosed as chronic maxillary sinusitis with OAF. However patient did not respond to any treatment approach and later presented with a more progressive lesion involving maxillary sinus. A cytosmear stained with periodic acid Schiff stain, revealed the presence of numerous candidal hyphae. Finally, case was diagnosed as OAF with a superadded candidal infection. Patient responded well to antifungal treatment followed by reclosure of OAF. We should not neglect a simple cytological examination which may prevent wrong diagnosis and wrong treatment.

No MeSH data available.


Related in: MedlinePlus