Oral Manifestations of Sinonasal Mucormycosis in Post-COVID Patients with Diabetes Mellitus: Three Case Reports

Abstract

ABSTRACT Sinonasal mucormycosis is a debilitating disease known to affect the nose, paranasal sinuses, orbit, and brain parenchyma caused by a group of opportunistic fungal organisms called mucormycetes. The incidence of mucormycosis cases had increased during the pandemic. Mucormycosis commonly involves the rhinomaxillary region in patients with uncontrolled diabetes mellitus, hematological malignancies, prolonged corticosteroid therapy, or immunodeficiency state but has lately been reported as one of the post-COVID-19 complications. For more than a century, diabetic patients have been considered as immunosuppressed due to defects in phagocytosis and microbial killing. Post-COVID-19 patients with mucormycosis often report to the dentist at an early stage with tooth pain usually radiating or later with facial swelling and periodontally weakened teeth. Early diagnosis of this potentially life-threatening disease and prompt treatment are of prime importance in reducing the morbidity and mortality associated with the disease. This article presents three cases of sinonasal mucormycosis in post-COVID-19/non-COVID-19 pneumonia-like symptoms recovered diabetic patients. This paper stresses the importance of identifying oral signs and symptoms that will help in the management of disease at an early stage and about the oral rehabilitation options in maxillectomy cases. CLINICAL RELEVANCE TO INTERDISCIPLINARY DENTISTRY As healthcare providers, we play a vital role in the early detection of mucormycosis cases.