Sequence of oral manifestations in rhino-maxillary mucormycosis

Abstract

Mucormycosis, caused by saprophytic fungi of the order Mucorales of the class Zygomycetes, is a rare opportunistic fungal infection, which has a rapidly progressive and fulminant course with fatal outcome. These fungi are ubiquitous, found in soil, bread molds, decaying fruits and vegetables. The most common form of mucormycosis is rhinocerebral and is usually seen in uncontrolled diabetes mellitus or in immunocompromised patients. This fungus invades the arteries, leading to thrombosis that subsequently causes necrosis of hard and soft tissues. We report a case of palatal perforation by rhino-maxillary mucormycosis in an immunocompromised patient. The aim of this article is to draw attention to the clinical presentation and pathogenesis of mucormycosis and to emphasize the need for high degree of suspicion in its diagnosis and management.

A meta‐analysis of survival factors in rhino‐orbital‐cerebral mucormycosis—has anything changed in the past 20 years?

“…In total, 210 case reports were identified from the literature search and reviewed, of which 175 contained sufficient clinical data to be analysed. These were derived from a total of 140 papers (some papers contained multiple case reports) . Larger case series were usually excluded due to a lack of chronological data (refer to Figure for PRISMA flow diagram).…”

Severe falciparum malaria complicated by prolonged haemolysis and rhinomaxillary mucormycosis after parasite clearance: a case report

“…This category is further divided into 2 subtypes: the highly aggressive, often fatal rhino-ocular-cerebral form and the less fatal rhino-maxillary form. The latter subtype manifests as necrosis of the palate due to angioinvasion and thrombosis of the sphenopalatine and greater palatine arteries [ 38 , 39 ].…”

“…The sinus involvement and presence of fungal hyphae makes acute necrotizing gingivitis unlikely. Most cases of rhinocerebral mucormycosis involve both sides of the palate, however hemi-palatal involvement has been reported [ 38 , 39 ]. This patient presented with typical symptoms of rhinomaxillary mucormycosis including fever, headache, lethargy, pain and swelling of the maxillary sinus.…”

Literature Review: HYPERBARIC OXYGEN THERAPY ON MUCORMYCOSIS INFECTION IN ORAL CAVITY

“…Hyperbaric oxygen therapy has been used as an adjunct to aggressive surgical debridement, amphotericin B therapy, control of any underlying predisposing conditions by aiding neovascularization and subsequent healing (Arya et al 2015) Other treatment modalities include heparinization, avoidance of steroids, oral potassium iodide, supportive care with vitamin supplementation, hyperbaric oxygen therapy, granulocyte colony stimulating factor (G-CSF) and topical application of Amphotericin-B (Doni et al 2011). Adjunctive hyperbaric oxygen should also be used when available.…”