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. 2023 Aug;9(4):623-629.
doi: 10.1002/cre2.743. Epub 2023 May 1.

Atypical clinical features of post COVID-19 mucormycosis: A case series

Hassanien A Al-Jumaily  1   2 , Auday M Al-Anee  1   2 , Ahmed F Al-Quisi  1   3
Affiliations

Atypical clinical features of post COVID-19 mucormycosis: A case series

Hassanien A Al-Jumaily et al. Clin Exp Dent Res. 2023 Aug.

Abstract

Objectives: This case series aims to evaluate patients affected with post COVID-19 mucormycosis from clinical presentation to surgical and pharmacological treatment to improve the disease prognosis.

Material and methods: This case series was conducted at a specialized surgery hospital in Baghdad Medical City for over 10 months. Fifteen cases who had mild to severe COVID-19 infections followed by symptoms similar to aggressive periodontitis, such as mobility and bone resorption around the multiple maxillary teeth, were included in this case series.

Results: All patients did not receive COVID-19 vaccination; seven had a history of diabetes mellitus type 2, another five patients had a history of diabetes-like syndrome during the COVID-19 infection, and the remaining three patients had no history of any systemic diseases. No intracranial involvement was seen in all patients, and bilateral sinus involvement was seen in three patients.

Conclusion: Being highly suspicious of all patients affected with COVID-19 is highly recommended to avoid the complications of the late diagnosis of mucormycosis. In addition, our knowledge and methods in diagnosing and treating classical mucormycosis should be modified regarding post COVID-19 mucormycosis.

Keywords: COVID-19; diabetes mellitus; mucormycosis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Normally attached mucosa overlying hypermobile maxillary teeth with abnormal yellowish bone from the incision made in the buccal vestibule for decompression of buccal space cellulitis.
Figure 2
Figure 2
(a) CBCT coronal section showed an obliterated right maxillary air sinus and fluid collection on the left side. (b) Extraction and curettage of the affected teeth and bone on the right side. Suturing with 3/0 black silk sutures to approximate and hold the iodoform pack in place.
Figure 3
Figure 3
(a) CBCT coronal view showed bilateral obliterated left maxillary sinus air cavity. (b) Surgical removal of the affected teeth and curettage of the affected sinus cavity. (c) Specimens sent for histopathological examination. (d) Clinical appearance of the maxillary defect after 10 months. (e) Patient wearing the obturator. (f) CBCT coronal view after 10 months of follow‐up showed clear sinus cavity with good response to mechanical debridement and antibiotic therapy.
Figure 4
Figure 4
(a) An axial view of CBCT showed obliterated maxillary air sinuses on both sides. (b) Severe bone resorption affecting the buccal bone plates on the right side of the maxilla. (c) Surgical extraction and curettage of the affected teeth and bone. (d) Complete re‐epithelization with no disease recurrence after 4 months of follow‐up.
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