Rhino cerebral mucormycosis. A report of two cases and review of literature.

Abstract

Mucormycosis is caused by fungi of the order Mucorales and is one of the fulminant and fatal mycotic infections known to human beings with a high mortality rate. Rhinocerebral mucormycosis is the most common type and its extension to the orbit and brain is quite usual. It is commonly reported in immunocompromised patients such as poorly controlled diabetes mellitus, blood dyscrasias, malnutrition, neutropenia, iron overload, organ transplant, and immunosuppressive therapy. Mucormycosis is on the rise with an increase in incidence of Diabetes mellitus and HIV infection leading to immunocompromised status of the patient. Here in, reporting two cases of rhinocerebral mucormycosis in two uncontrolled diabetic patients with deep palatal perforation in one case and this is a rare and late occurrence. Both the patients were successfully treated with a combination of surgical debridement and systemic amphotericin B administration. By presenting this case report we would like to point out that mucormycosis should be included in the differential diagnosis of hard palate ulcers and cellulitis. Key words: Fungal infection, mucorales, immunocompromised status, palatal perforation, diabetes mellitus.Sujatha RS., Rakesh N.,Deepa J., Ashish L., Shridevi B. Rhino cerebral mucormycosis. A report of two cases and review of literature. J Clin Exp Dent. 2011;3(3):e256-60.

Rare opportunistic bread mold fungal infection of maxillary sinus in a diabetic patient

“…[ 4 ] Mucorales are ubiquitous fungi that are found worldwide on fruits, air, bread, compost pile, animal excreta, and soil as saprophytes and cause a life-threatening rare fungal infection known as mucormycosis. [ 2 5 ] Paltauf in 1885 gave the first histologic description of generalized mucormycosis. [ 5 6 ] The fungi and spores of Mucorales have minimal pathogenicity in normal individuals; however, they can cause fulminating opportunistic infection (mucormycosis) in immunocompromised individuals.…”

“…[ 1 5 ] It usually starts in the nasal mucosa or palate and extends to involve the paranasal sinuses. [ 2 3 ] From the sinuses, it then involves the retro-orbital region after spreading through either direct extension or through the lacrimal, angular, and ethmoidal vessels. [ 2 ] This once it invades the arteries leads to thrombosis of the blood vessels and causes necrosis of the hard and soft tissues.…”

“…Mucormycosis is a rare fulminant, fatal opportunistic mycotic infection that affects the human beings. [ 1 2 ] According to analysis, India is the most affected country by mucormycosis contributing to 44.3% of the entire cases reported worldwide, followed by the USA and Australia. The predisposing risk factors for mucormycosis in India may include socioeconomic conditions, poor hygienic conditions, and diabetes mellitus.…”

Rhino- Orbito Cerebral Mucormycosis – Uncontrolled, Untimely and Unsaved

“…Rhino-orbitocerebral mucormycosis is most common type of mucormycosis It is more common in patients with poor diabetic control (70%) [6], were immunological response to infections will be reduced. In literature, there were total of 16 cases of mucormycosis reported secondary to extraction of tooth.…”

Rhino-Orbito-Cerebral Mucormycosis: Neglected Mycoses in Childhood Malignancies

“…Broad, thin-walled, branching aseptate hyphae with angioinvasion and tissue necrosis are indicative of mucormycosis. Fungal culture is another tool and utilizes sabouraud agar [12].…”