Sino-Maxillary Mucormycosis of Iatrogenic etiology in an immunocompetent patient - Importance of early diagnosis and prompt management

Abstract

Sino-maxillary mucormycosis is an opportunistic, aggressive, invasive and fulminant fungal infection, which has the ability to rapidly cross anatomical barriers, causing extensive hard and soft tissue destruction, leading to significant cosmetic deformity, functional debility and morbidity. It usually affects susceptible, debilitated or immunocompromised individuals. A comprehensive Review Paper is presented, with a descriptive report on an unusual Case presentation, involving the dentoalveolar complex which thereafter invaded the maxillary antrum, in an otherwise healthy, adult patient with nil comorbidities. A probable intraoral portal of entry, and a likely iatrogenic etiopathogenesis resulting from inoculation of the fungus or its spores during dental extractions carried out in an unsterile setting, has been considered and elucidated. An emphasis has been placed on according a high index of suspicion in diagnosis of this fungal infection even in immunocompetent and healthy adults, presenting with a seemingly simple, deceptively indolent odontogenic infection. The importance of careful, albeit rapid differential diagnosis, and a prompt and aggressive medical-surgical treatment protocol instituted immediately following a confirmatory diagnosis, helps in limiting the spread and degree of destruction which can be caused by this potentially lethal fungal infection.