Mandibular Mucormycosis in Immunocompromised Patients: Report of 2 Cases and Review of the Literature

Infantile splenorenopancreatic mucormycosis complicating neuroblastoma

“…It is most frequently observed in patients with hematologic malignancies and stem cell transplant recipients, due to the presence of more predisposing factors such as use of immunosuppressive agents and multiple admissions to oncology departments, whereas in neuroblastoma the most important risk factor is neutropenia, with prophylactic antifungal treatment being a less important factor. Hence, the incidence of mucormycosis among patients with neuroblastoma is extremely rare, with only a handful of reports described in the literature . Taken all together, initial splenic mucormycosis as the first presentation invading to adjacent kidney and pancreas in infantile neuroblastoma has not been previously described.…”

“…Hence, the incidence of mucormycosis among patients with neuroblastoma is extremely rare, with only a handful of reports described in the literature. 11,12 Taken all together, initial splenic mucormycosis as the first presentation invading to adjacent kidney and pancreas in infantile neuroblastoma has not been previously described.…”

“…10 Furthermore, mucormycosis complicating neuroblastoma is an extremely rare entity, reported only in two patients; in a 6-year-old boy who developed isolated mandibular involvement and in a 3-year-old patient with involvement of the gastrointestinal tract, liver and kidneys disseminated from pulmonary mycosis. 11,12 It is most frequently observed in patients with hematologic malignancies and stem cell transplant recipients, due to the presence of more predisposing factors such as use of immunosuppressive agents and multiple admissions to oncology departments, 13 whereas in neuroblastoma the most important risk factor is neutropenia, with prophylactic antifungal treatment being a less important factor. Hence, the incidence of mucormycosis among patients with neuroblastoma is extremely rare, with only a handful of reports described in the literature.…”

Rhinocerebral mucormycosis: report of a rare case

“…Mucorales species are vasotropic, causing tissue infarctions, and the mucormycosis spectrum ranges from cutaneous, rhinocerebral, and sinopulmonary to disseminated and frequently fatal infections, especially in immune-compromised hosts (7). Reports have suggested that the ability of serum of immuno-compromised patients to inhibit Rhizopus invitro is reduced, which makes them suitable hosts to opportunistic fungal infections (8). In diabetic patients, especially with elevated blood sugar levels, the spores germinate, hypae develop, fungi begin an inexorable march through the tissues as blood vessels become involved, thrombosis occurs, resulting in tissue necrosis and fungi continue to grow in this devitalised tissue causing further damage to surrounding tissues (9).…”

Rhinocerebral zygomycosis with pansinusitis in a 14-year-old girl with type 1 diabetes: a case report and review of the literature

“…Even with successful treatment, Mucorales can reappear during future courses of chemotherapy and neutropenia [29]. There may be predictive factors on the evolution of complications: patients who presented with “blindness” seem to have a higher prevalence of survival (p ≤ 0.04) while patients who presented with “decreased consciousness” seem to have an higher prevalence of death (p ≤ 0.04).…”