Mucormycosis of the jaw after dental extractions: two case reports

Abstract

Mucormycosis is a rare opportunistic fungal infection, which is mainly reported to occur in patients with immunocompromised conditions such as uncontrolled diabetes mellitus and leukaemias. In this paper, two cases of mucormycosis are reported after dental extractions. The first case of mucormycosis occurred in the maxilla and mandible of a 14 year old male patient undergoing chemotherapy for acute myeloid leukaemia. The second case occurred in the mandible of a 49 year old male patient with a recently diagnosed type-2 diabetes mellitus, presenting with ketoacidosis and underlying undiagnosed acute lymphoblastic leukaemia. The outcome of these reported cases of mucormycosis was favourable after comprehensive surgical and medical management.

Keywords: Mucormycosis; Oman; case report; complication of dental extraction; rhinocerebral mucormycosis.

Figure 1:

Axial CT of case 1 showing obliteration of the right maxillary sinus (black arrowhead) and soft tissue swelling over the right infraorbital region (white arrowhead)

Figure 2:

Coronal CT of case 1 showing obliteration of the right sinus causing blockage of the medial conchae and extension to the right ethmoid sinus (arrowhead)

Figure 3:

Photomicrograph from retro-molar area showing area of bone necrosis with infestation of fungal hyphae (Haematoxylin and eosin stain, original magnification _400)

Figure 4:

Photomicrograph from retro-molar region showing elongated, broad, non-septate branching hyphae within the tissue and the bone marrow space (Gomori methenamine silver nitrate stain, original magnification _400)