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Review
. 2019 Jan-Jun;9(1):168-173.
doi: 10.4103/ams.ams_218_18.

Maxillary Fungal Osteomyelitis: A Review of Literature and Report of a Rare Case

Ankita Srivastava  1 , Mounabati Mohpatra  1 , Ashoka Mahapatra  2
Affiliations
Review

Maxillary Fungal Osteomyelitis: A Review of Literature and Report of a Rare Case

Ankita Srivastava et al. Ann Maxillofac Surg. 2019 Jan-Jun.

Abstract

Fungal osteomyelitis is a life-threatening and seldom seen opportunistic infection. It is commonly an affectation of the nose and paranasal sinuses within the orofacial region. It is an aggressive infection that needs to be addressed promptly to prevent fatal consequences. Here, we present a case of a 62-year-old female who presented with complaints of pain and pus discharge from the extraction socket of the left maxillary 23, 24, 25, 26 teeth. She had a history of uncontrolled diabetes mellitus. On further investigation, using diagnostic and Interventional aids, a final diagnosis of maxillary fungal osteomyelitis was made. The infective fungal agents were a mixture of Mucorales and Aspergillus species. A review of all literatures on the subject in the past 13 years using different search engines showed that craniofacial fungal infections with primary maxillary involvement are a rare phenomenon. The primary aim of reporting this case, therefore, is to highlight its rarity, presentation, management and most importantly the outcome of management.

Keywords: Aspergillosis; concomitant infection; fungal osteomyelitis; mucormycosis; opportunistic infection.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Diagram 1
Diagram 1
Distribution of underlying debilitating diseases
Figure 1
Figure 1
Image showing osteomyelitic changes of the left maxillary alveolus
Figure 2
Figure 2
Noncontrast computerized tomographic scan of face showing osteolysis of maxilla (Left) involving maxillary antrum
Figure 3
Figure 3
Three-dimensional reconstruction of computed tomography showing bone destruction and erosion of the left maxilla with antral involvement
Figure 4
Figure 4
Photograph of the patient following debridement and sequestrectomy performed from the palatal aspect
Figure 5
Figure 5
Microscopic view showing branching fungal hyphae and spores (Hematoxylin and Eosin Stain with, ×10)
Figure 6
Figure 6
Microscopic view showing non septate wide branched hyphae (PAS, ×40)
Figure 7
Figure 7
Microscopic view showing nonseptate wide branched and septate acute angle branching hyphae (GMS, ×40)
Figure 8
Figure 8
Follow-up image after 2 years
See this image and copyright information in PMC

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