Mucormycosis of oral cavity: a descriptive case report from a tertiary care hospital

Binay Kumar; Nidhi Prasad

doi:10.18203/2320-6012.ijrms20222539

Authors

Binay Kumar Department of Pathology, NSMCH, Bihta, Patna, India
Nidhi Prasad Department of Community Medicine, IGIMS, Patna, India CH

DOI:

https://doi.org/10.18203/2320-6012.ijrms20222539

Keywords:

COVID-19, Mucormycosis, Fungal infection, Opportunistic infection, H and E stain

Abstract

We presented an interesting case report of mucormycosis (Rhizopus Oryzae) in a recovered COVID-19 patient, its diagnosis and identification. The patient in past visited our institute with symptoms of COVID-19, she was a known case of tuberculosis and was taking ATT and diabetic (DM-2) patient. She was diagnosed COVID positive and successfully treated at our institution and discharged after recovering from the complications. After approximately two months of getting discharged from the hospital she again visited the post COVID clinic with symptoms of fever and numbness around face and on routine examination a blackish tissue like growth seen involving the hard palate and post nasal area. Mucormycosis (phycomycosis, zygomycosis) is an acute opportunistic infection generally develops secondary to debilitating diseases. But increased incidence was noticed in COVID-19 affected individuals. In head, neck and oral cavity the mold usually gains entry through respiratory route involving maxillary sinuses and oral cavity. The fungus causes great damage to the anatomical structures leading its necrosis. Hence an early diagnosis and surgical interventions is must for a good prognosis, decreasing morbidity and mortality. Extensive Research needs to be carried out in COVID patient specially treatment to prevent and reduce the cases of opportunistic infection in order to reduce its incidence and morbidity/mortality.

Metrics

Metrics Loading ...

Author Biographies

Binay Kumar, Department of Pathology, NSMCH, Bihta, Patna, India

Assistant Professor, Department of Community Medicine

Nidhi Prasad, Department of Community Medicine, IGIMS, Patna, India CH

Assistant Professor, Department of Pathology

References

Jayaweera M, Perera H, Gunawardana B, Manatunge J. Transmission of COVID-19 virus by droplets and aerosols: a critical review on the unresolved dichotomy. Environ Res. 2020;188:109819.

WHO. Fact sheet: Modes of transmission of virus causing COVID-19: implications for IPC precaution recommendations. Available at: https://www.who.int/news-room/commentaries/detail/modes-of-transmission-of-virus-causing-covid-19-implications-for-ipc-precaution-recommendations. Accessed on 1 August 2022.

Szarpak L, Wisco J, Boyer R. How healthcare must respond to ventilator-associated pneumonia (VAP) in invasively mechanically ventilated COVID-19 patients. Am J Emerg Med. 2021;48:361-2.

Salehi M, Ahmadikia K, Badali H, Khodavaisy S. Opportunistic fungal infections in the epidemic area of COVID-19: a clinical and diagnostic perspective from Iran. Mycopathologia. 2020;185(4):607-11.

Prakash H, Ghosh AK, Rudramurthy SM, Singh P, Xess I, Savio J, et al. A prospective multicenter study on mucormycosis in India: Epidemiology, diagnosis, and treatment. Med Mycol. 2019;57(4):395-402.

Patel A, Kaur H, Xess I, Michael JS, Savio J, Rudramurthy S, et al. A multi-centre observational study on the epidemiology, risk factors, management and outcomes of mucormycosis in India. Clin Microbiol Infect. 2020;26(7):944.

Patel AK, Patel KK, Patel K, Gohel S, Chakrabarti A. Mucormycosis at a tertiary care centre in Gujarat, India. Mycoses. 2017;60(6):407-11.

Jeong W, Keighley C, Wolfe R. The epidemiology and clinical manifestations of mucormycosis: a systematic review and meta-analysis of case reports. Clin Microbiol Infect. 2019;25(1):26-34.

Chander J, Kaur M, Singla N, Punia R, Singhal S, Attri A, et sl. Mucormycosis: battle with the deadly enemy over a five-year period in India. J Fungi. 2018;4(2):46.

Werthman-Ehrenreich A. Mucormycosis with orbital compartment syndrome in a patient with COVID-19. Am J Emerg Med. 2021;42:264.

Deutsch PG, Whittaker J, Prasad S. Invasive and non-invasive fungal rhinosinusitis-a review and update of the evidence. Medicina (Kaunas). 2019;55(7):319.

Marc EG, Lindy PF, Carrie K, Misha R. (2012). Subcutaneous and deep mycoses: zygomucosis/ mucormycosis. Cutaneous Manifestations of Infection in the Immunocompromised Host. 2nd ed. Springer; 2012: 51-8.

Prakash H, Ghosh AK, Rudramurthy SM, Paul R.A, Gupta S, Negi V, et al. The environmental source of emerging Apophysomyces variabilis infection in India. Med Mycol. 2016;54(6):567-75.

Prakash H, Singh S, Rudramurthy SM, Singh P, Mehta N, Shaw D, et al. An aero mycological analysis of Mucormycetes in indoor and outdoor environments of northern India. Med Mycol. 2020;58(1):118-23.

Gupta S, Goyal R, Kaore NM. Rhino-orbital-cerebral mucormycosis: battle with the deadly enemy. Indian J Otolaryngol Head Neck Surg. 2020;72(1):104-11.

Groote CA. Rhinocerebral phycomycosis. Arch. Otolaryngol. 1970;92(3):288-92.

Bawankar P, Lahane S, Pathak P, Gonde P, Singh A. Central retinal artery occlusion as the presenting manifestation of invasive rhino-orbital-cerebral mucormycosis. Taiwan J Ophthalmol. 2020;10(1):62-5.

Parsi K, Itgampalli RK, Vittal R, Kumar A. Perineural spread of rhino-orbitocerebral mucormycosis caused by Apophysomyces elegans. Ann Indian Acad Neurol. 2013;16(3):414.