This case report describes a rare occurrence of pyogenic granuloma (PG) in the hard palate deviating from its typical gingival location that led to the formation of an alveolar cleft. The aggressive growth pattern of the lesion, with atypical progression from a pedunculated nodule to an alveolar cleft, raised concern. The diagnosis was based on magnetic resonance imaging and computed tomography findings, which revealed a tadpole-shaped lesion originating from the midline hard palate. The differential diagnosis included a minor salivary gland tumor. Surgical excision was performed under general anesthesia and resulted in a mucosal defect without nasolabial fistula formation or bone exposure. The palatal defect was packed with oxidized regenerated cellulose and closed with Vicryl Rapide sutures, both of which contributed to the patient\'s successful outcomes. Our comprehensive approach, extending across the stages of surgical planning, execution, and postoperative care, demonstrated the advantages of a multidisciplinary strategy for the accurate diagnosis and effective treatment of palatal PGs. This report makes a meaningful contribution to the existing literature on common oral lesions by emphasizing the importance of a broad differential diagnosis and a systematic approach to oral pathologies. It also raises clinical awareness of PGs with atypical presentations and the diagnostic challenge that they pose.

Recurrent pyogenic cholangitis (RPC), which is most commonly seen in Asian populations, is characterized by strictures and dilatation of both intrahepatic and extrahepatic bile ducts, along with the formation of pigmented stones inside the ducts. The most common symptoms are recurrent right upper quadrant pain, jaundice, and fever. Additionally, leukocytosis and elevated alkaline phosphatase and bilirubin levels may also be present. We report the case of a 43-year-old Bangladeshi male patient with a medical background of chronic hepatitis B infection and recurrent liver abscesses who presented to the emergency department with abdominal pain and fever lasting for two days. Given the clinical context of our patient, a diagnosis of RPC was made, and the patient was referred to a higher-level center for further management. Our case highlights the importance of considering RPC as part of the differential diagnosis in patients presenting with recurrent liver abscesses and features of ascending cholangitis.

UNASSIGNED: Pyogenic liver abscess (PLA) is a potentially life-threatening condition characterized by the formation of space-occupying lesions within the liver parenchyma. Despite advancements in diagnostic imaging and antibiotic therapies, complications such as biliary fistula formation can arise, posing challenges in management.
METHODS: This case study presents a 23-year-old male patient with PLA complicated by a biliary fistula. Diagnostic imaging via CT scan and MRI confirmed a liver abscess and biliary dilation. The patient underwent a second drainage for ascitic fluid following the initial percutaneous liver catheter drainage.
UNASSIGNED: The patient responded positively to the treatment, with reduced abscess size and fistula resolution. While endoscopic interventions offer promising results, their limited availability necessitates alternative treatment strategies, such as percutaneous drainage and appropriate antibiotics.
CONCLUSIONS: This case emphasises the importance of individualized management approaches for PLA complicated by biliary fistulas. Despite the challenges, successful outcomes can be achieved through careful management and appropriate treatment strategies.

A halo phenomenon describes a skin neoplasm that is surrounded by a hypopigmented or white halo. Halo lesions have been observed in association with an epithelial neoplasm (seborrheic keratosis), a fibrous lesion (surgical scar), a keratinocyte malignancy (basal cell carcinoma), melanocytic neoplasms, and vascular lesions. Benign lesions (café au lait macules and nevi) and malignant tumors (primary and metastatic melanoma) are melanocytic neoplasms that have developed perilesional halos. Halo nevi are a commonly occurring manifestation of a halo phenomenon; however, perilesional hypopigmented halos have also been observed around nevi in patients following treatment with antineoplastic drugs, acquisition of COVID-19 (infection and vaccine), the occurrence of a visceral tumor (including not only melanoma, but also papillary thyroid carcinoma and neuroendocrine cancer of the lung), surgery (such as the excision of a primary melanoma), and Turner syndrome. A halo phenomenon has also been observed in patients with congenital (capillary malformation-arteriovenous malformation and congenital hemangioma) or acquired (angioma, eruptive pseudoangiomatosis, infantile hemangioma, and lobular capillary hemangioma) vascular lesions. In summary, a halo phenomenon can occur in association with primary lesions of various embryologic derivations. Most commonly, they have been observed in around nevi and vascular tumors. Halo lobular capillary hemangioma can be added to the list of acquired vascular lesions with the potential to develop a halo phenomenon. The preservation of melanocytes with loss of melanin pigment expression in the reported patient suggests the possibility that a post-inflammatory etiology may be responsible for the genesis of her halo lobular capillary hemangioma.

Hepatogastric fistula following pyogenic liver abscess (PLA) is a rare and fatal complication, and only a handful of cases have been reported without co-existing comorbidities of Brugarda syndrome.
UNASSIGNED: A 22-year-old male presented to the emergency room with a known case of Brugarda pattern ECG with chief complaints of on-and-off abdominal pain and fever for 2 weeks and shortness of breath for one day. On evaluation, echocardiography showed a clot in the inferior vena cava (IVC) and right atrium (RA), and on computed tomography scan of the abdomen revealed a liver abscess with transmural gastric perforation. During, an exploratory laparotomy where a fistula joining the left lobe of the liver and stomach was detected, and an emergency excision was done. The patient was shifted to the ICU and later developed septic shock, which was managed medically.
UNASSIGNED: Usually, thrombosis of the portal vein and the hepatic vein is a very common complication of a PLA but vascular complications like IVC, RA thrombosis, and hepatogastric fistula have been reported rarely. Our case is peculiar hepatogastric fistulization along with IVC/RA clots in a patient with Brugarda pattern ECG. The typical clinical manifestation of a patient with hepatogenic fistula is absent in our patient and presented with an on-off type of fever, epigastric pain, and shortness of breath and was managed surgically.
UNASSIGNED: Hepatogasric fistula, thrombosis of the IVC, and RA are a rare complications of PLA. The patient with Brugarda syndrome is at high risk as its clinical manifestation gets exaggerated during sepsis.

BACKGROUND: Amoebic liver abscess (ALA) is the fourth cause of mortality by parasitic infection. This study aimed to assess clinical, radiological and therapeutic characteristics of patients admitted for amoebic liver abscess compared to pyogenic abscess in a French digestive tertiary care-centre.
METHODS: The charts of patients hospitalized for a liver abscess between 2010 and 2020 were retrospectively assessed then separated in two groups: amoebic liver abscess and pyogenic liver abscess from portal underlying cause. Clinical and radiological data were collected for univariate comparison.
RESULTS: Twenty-one patients were hospitalized during the time of the study for ALA, and 21 patients for pyogenic liver abscess with a portal mechanism. All patients hospitalized for ALA lived in and/or had travelled recently in an endemic area. In comparison with patients hospitalized for pyogenic abscess, patients admitted for ALA were younger (44years old vs. 63years old, P<0.001), had less comorbidities (5% vs. 43% of patients with at least one comorbidity, P<0.01), a longer median duration of symptoms (10days vs. 3days, P=0.015), abdominal pain (86% vs. 52%, P=0.019), and a slighter leucocytosis (9600G/L vs. 15,500G/L, P=0.041) were more frequent. On the abdominal tomodensitometry, density of ALA was higher (34 vs. 25 UH, P<0.01), associated with a focal intra-hepatic biliary dilatation and less often multiloculated.
CONCLUSIONS: While rare in western countries, amoebic liver abscess care should not be underestimated. The presence of a solitary liver abscess of intermediate density on computed tomography, occurring on a patient returning from an endemic zone should lead the physician to a possible diagnosis of ALA.

Pyogenic granuloma (PG) is a vascular tumor originating from the skin and mucosal membranes. The most common sites include the oral and nasal cavities. It appears as a solitary erythematous lesion that bleeds easily. Various triggers were present in the literature such as pregnancy, drugs, and trauma. Trauma to the nose such as nose piercing was reported several times. However, there has been only one case study that has reported rhinoplasty as a potential trigger for the development of PG. Here, we report a case of recurrent PG following rhinoplasty in a 45-year old female.

UNASSIGNED: Hemangiomas are benign tumors that are very common in the head and neck region. However, intravascular hemangiomas are very rare. Hemangiomas are classified as capillary, cavernous or mixed tumors according to the proliferating cells. Ultrasound, computed tomography, MR imaging and angiography are useful diagnostic tools and are generally required when planning surgical treatment. Definitive diagnosis is established by histopathological examination, differentiating hemangiomas from other vascular tumors or malignancies.
UNASSIGNED: We present a rare case of capillary hemangioma protruding from the external jugular vein. In our patient, the tumor was totally removed under local anesthesia. No complications and no recurrence were observed in the following two years.
UNASSIGNED: Intravascular tumors can present as neck masses and a definitive diagnosis is made by histopathological examination. Imaging tools provide important information about anatomy, the extent of the tumor, and for surgical planning.

Burkholderia cepacia is an important pathogen of humans in both immunocompromised and hospitalized patients. This uncommon pathogen is established to be the cause of pyogenic spondylodiscitis in only seven cases in the medical literature. Here, we report the cases of four patients who were diagnosed over two years period with Burkholderia cepacia spondylodiscitis and were successfully managed by appropriate antimicrobial treatment after open surgical biopsy was done for debridement and microbiological identification.

Pyogenic liver abscesses (PLA) develop from the spread of infection through the portal circulation, biliary infections or arterial hematogenous seeding in the setting of systemic infections. PLA are often poly-microbial and are uncommonly reported to be due to anaerobic species. We report the case of a previously healthy, immunocompetent 63-year-old man with hepatic abscesses as a result of Fusobacterium nucleatum periodontal disease. In addition, a systemic review of the literature is performed. Fusobacterium is a very rare cause of PLA in immunocompetent hosts with only a handful of cases reported in the literature. Although anaerobic infections such as Fusobacterium most often occur in immunocompromised individuals, clinicians should have a high index of suspicion in immunocompetent patients with periodontal disease or chronic stomatitis.