Necrosis of maxilla, nasal, and frontal bone secondary to extensive rhino-cerebral mucormycosis

Abstract

Mucormycosis is an opportunistic fulminant fungal infection caused by zygomycetes. This fungus can cause a variety of infections in human beings, particularly in the uncontrolled diabetes mellitus. Zygomycetes impinge into the vascular network, resulting in thrombosis and necrosis of the surrounding hard and soft tissues. The infection begins in the nose and paranasal sinuses due to inhalation of fungal spores and spread to orbital and intracranial structures either by direct invasion or through the blood vessels. Sinus mucormycosis is often accompanied by a poor prognosis and a high mortality rate. Hence, aggressive surgical intervention with antifungal therapy is usually necessary. Early diagnosis and prompt treatment can reduce the mortality and morbidity of this lethal fungal infection. We report a case of aggressive rhino-cerebral mucormycosis in a 58-year-old female patient with uncontrolled diabetes mellitus.

Mucormycosis in immunocompetent patient resulting in extensive maxillary sequestration

“…The basis of mucormycosis treatment remains a combination of extensive surgical debridement and amphotericin B for a protracted period of 4–6 weeks. Although not currently used as first-line treatment, the concurrent use of posaconazole, a triazole antifungal drug, has been shown to be effective against mucormycosis and use has been increasingly reported when amphotericin B had to be discontinued due to adverse side effects[ 11 ] [ Figure 8 ].…”

Oral mucormycosis in an 18-month-old child: a rare case report with a literature review

“…Cutaneous mucormycosis has a mortality rate of 17%, whereas rhinocerebral, pulmonary, and gastrointestinal mucormycosis have mortality rates of 67%, 83%, and 100%, respectively. However, early medical (systemic administration of amphotericin B) and surgical (radical surgical intervention) treatment limits the spread of fungal infection to vital regions of the body and improves patient survival by 80% 35 .…”

Unilateral rhino–orbital–cerebral mucormycosis with contralateral endogenous fungal endophthalmitis

“…6 This pathogenesis contradicts the usual route of infection, which begins in the nose and paranasal sinuses from the inhalation of fungal spores. 8 Thereafter, orbital involvement is due to contiguous spread from the sinuses or via the nasolacrimal duct. Further intracerebral spread extends from the orbit via the orbital apex, orbital vessels, or cribriform plate.…”