Mucormycosis of the maxillary sinus in an immunocompetent woman with oro-antral fistula – a case report

Abstract

Mucormycosis is a very rare fungal infection, characterized by vascular invasion, rapid progression and high mortality. Individuals suffering from systemic diseases influencing the immune system are predisposed to this infection which is caused by saprophytic fungi belonging to the class of Mucormycetes in the order of Mucorales. In this paper, we present an unusual case of mucormycosis of the maxillary sinus in an immunocompetent patient with oro-antral fistula. The infection may occur in either a fulminant or chronic form. In the patient described, the disease was chronic and characterized by a mild course with local symptoms. In the disseminated form of mucormycosis, the mortality rate is almost 100%. A definitively higher survival rate is observed in immunocompetent patients with a localized form of the infection. Diagnosis of the disease is very difficult because of its clinical and radiological similarity to the more common fungal infection, aspergillosis. Early diagnosis plays a key role in the course of treatment and allows to reduce the scope of surgical intervention. According to most authors, first line treatment should be the liposomal form of amphotericin B. Some also advise surgical treatment involving the removal of fungal masses. In the patient described, both surgical and pharmacological treatment was conducted resulting in the complete resolution of the fungal infection after 12 months.