Mucormycosis: A possible diagnosis in spontaneous necrotic s
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A 67-year male reported a complaint of mild pain, exposed bone, and pus discharge from the left quadrant of the upper jaw with a duration of 1 month. He is a known diabetic for the past 10 years. He gave a history of extraction of his tooth himself. On intra-oral examination, a grayish-colored bone, denuded of its mucoperiosteum, was seen on the left side of the maxillary alveolus, extending to involve the hard palate. This dentoalveolar segment was mobile. A Computed Tomography scan revealed a thickening of the maxillary sinus lining. Histopathological examination confirmed the diagnosis of mucormycosis. So, Sequestrectomy and debridement of the affected bone were done. Antifungal therapy was administered in the form of Lipid complex Amphotericin B, 250 mg IV 12 hourly for 3 weeks, which was slowly infused over 4–6 h. The patient’s blood glucose levels were closely monitored. Postoperatively the patient's condition improved significantly. An obturator was fabricated by the prosthodontist to cover the palatal defect.

A post-operative follow-up after 2 months revealed satisfactory healing and there was no clinical evidence of mucormycosis. The general status of the patient also improved and vital signs were within normal limits.
Mucormycosis is an invasive fungal infection caused by fungi of the order of Mucorales. It was first described by Paltauf in 1885. It is the third most common opportunistic fungal infection after candidiasis and aspergillosis. Rhizopus, along with Mucor and Lichtheimia account for about 70–80% of all the cases of mucormycosis. These saprophytic organisms exist in the soil, manure, fruits, starchy foods and are frequently found to colonize the oral mucosa, the nasal mucosa, the paranasal sinuses, and the pharyngeal mucosa of asymptomatic patients.

Source:https://www.sciencedirect.com/science/article/pii/S2210261220309536
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