PMC7339033_01
Clinical aspects:Initial aspect of the infectious process (A); Erythematous lesion with the presence of granules (B); Lesion after surgical debridement (C); Initial healing 4 days after the primary intervention (D).
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A 57-year-old male was admitted with a swollen region of 4 cm in diameter on the right parasymphyseal region, mild local pain, no fever or other systemic symptoms (Fig. 1A). The soft tissues in this region were tender and the presence of yellowish granules with different dimensions were noticed (Fig. 1B). A biopsy sample was taken for histological evaluation (Fig. 1C). The patient was followed-up periodically and a very favourable healing began to occur on the fourth postoperative day, with no more purulent drainage (Fig. 1D).
Panoramic radiography: teeth with severe periodontal disease:31.41 and 42:but without the presence of bone rarefaction.
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Severe periodontal disease was found, but it was not related to the current cervicofacial infection (Fig. 2).
Images of histological examination at 10x (A and C) and 63x (B and D).
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It showed a chronic inflammatory infiltrate with granuloma formation surrounding collections of polymorphonuclear leukocytes and colonies of microorganisms (Fig. 3).
Clinical aspect 12 days after surgery.
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On the 12th postoperative day, an area of fibrosis could already be seen promoting wound closure in regions where the fistulas were previously located (Fig. 4).
Final clinical appearance after 4 weeks.
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Over a period of 4 weeks, the patient finished the antibiotic treatment, and the inflamed-infectious process healed, along with complete healing of the skin. (Fig. 5).