An Early and An Advanced Oral Mucormycosis Lesions

Case Series

Abstract

Introduction: Mucormycosis is a deep fungal infection caused by Mucorales. It is commonly found in immunocompromised patients and is considered the third most common fungal infection after candidiasis and aspergillosis.
Case report: This paper reports 2 cases of mucormycosis which involving oral cavity, lung, maxillary sinus, orbita and cerebral. The first case had hematology disorder with long-term corticosteroid therapy. The brownish oral pseudomembrane unresponsive to nystatin and mycafungin therapy. Second case had type 2 diabetes mellitus with perforated hard palate, rhinosinusitis, orbita infection and cerebral abscess. Direct mycology from oral specimens showed coenocytic hypha consistent with the Mucorales in both cases. Both cases showed responsiveness to amphotericin B therapy.
Discussion: Mucormycosis can be invasive to adjacent sites or angioinvasive to distant site, thus interdisciplinary team approach must be taken. In mucormycosis, early diagnosis and prompt treatment become important to prevent further spreading of infection and tissue destruction. Diagnostic procedure using oral specimen is an option.
Conclusion: Management of mucormycosis cases requires interdisciplinary teamwork. Early recognition of oral lesion of mucormycosis and diagnosis of mucormycosis is very important to prevent further damage and even death. Identification of Mucorales from oral lesion is beneficial since it is more accessible and non-invasive.