Diagnosis,treatment and maxillofacial rehabilitation in rhinocerebral mucormycosis patient: A case report and review of the literature |
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| Authors: | Rennan Luiz Oliveira Dos Santos Cintia Baena Elchin Vítor Ancheschi Guiguer-Pinto Dewton de Moraes Vasconcelos Maurício Domingues Ferreira Reinaldo Brito Dias Norberto Nobuo Sugaya Claudete Rodrigues Paula Neide Pena Coto |
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| Affiliation: | 1. Department of Stomatology, School of Dentistry - University of São Paulo, Av. Lineu Prestes, São Paulo 2227, Brazil;2. Department of Maxillofacial Surgery, Prosthetics and Traumatology, School of Dentistry - University of São Paulo, Av. Lineu Prestes, São Paulo 2227, Brazil;3. Department of Dermatology, School of Medicine - University of São Paulo, Av. Dr. Arnaldo, São Paulo 455, Brazil;1. Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran;2. Department of Parasitology, School of Allied Medical Sciences, Ilam University of Medical Sciences, Ilam, Iran;3. Department of Medical Parasitology and Mycology, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran;4. Department of Medical Microbiology and Parasitology, College of Health Sciences, Bayero University Kano, PMB 3011, Kano, Nigeria;5. Emam Reza Hospital, Sirjan School of Medical Sciences, Sirjan, Iran;1. Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, Hunan 410008, PR China;2. Institute for Rational and Safe Medication Practices, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan 410008, PR China;3. Department of Pharmacy Practice, College of Pharmacy and Health Sciences, Western New England University, Springfeld, MA 01119, USA;1. Pathological Anatomy Sector (SAP), Department of Epidemiology and Public Health, Federal Rural University of Rio de Janeiro (UFRuralRJ), BR-465 Km 7, Seropédica, RJ 23.890-001, Brazil;2. Centro Universitario de Tacuarembó, Universidad de la República, Ruta 5 Km 386, Tacuarembó, TA 45000, Uruguay;5. Post-Graduate Program in Animal Science in the Tropics, Federal University of Bahia, Salvador, BA, Brazil;1. Instituto de Medicina Tropical “Alexander von Humboldt”, Universidad Peruana Cayetano Heredia, Lima, Perú;2. School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Perú;3. Hospital Cayetano Heredia, Lima, Perú;4. Genomic Research Unit, Universidad Peruana Cayetano Heredia, Lima, Perú;5. Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/Consejo Superior de Investigaciones Científicas/Universidad de Sevilla, and Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Hospital Universitario Virgen del Rocío, Seville, Spain;6. Groupe d''Étude des Interactions Hôte-Pathogène (GEIHP)-Université d''Angers, Université de Brest, Brest, France;7. Laboratoire de Mycologie et Parasitologie, CHRU de Brest, Brest, France;8. Centre for Clinical Research in Infection and Sexual Health, Institute for Global Health, University College London, London, United Kingdom;9. Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom;10. Programa de Microbiología y Micología, Instituto de Ciencias Biomédicas (ICBM), Facultad de Medicina Universidad de Chile, Santiago, Chile |
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| Abstract: | Mucormycosis is an aggressive, rare and opportunistic infectious disease, with a high mortality rate. Etiologic agents are filamentous fungi, and infection among humans normally occurs through spore inhalation. A 61-year-old male individual, presenting left eye amaurosis, dark epistaxis, hyperalgesia and malodor underwent clinical examination, which detected ulcerative lesion and wide bone exposure in the hard palate and alveolar ridge. Direct microbiological examination, microbiological culture and lesion biopsy were performed. Non-septate smooth fungal hyphae forming right angles with each other were observed through the direct microbiological examination. Microbiological culture revealed fast-growing fungal colonies with cottony texture, identified as Rhizopus sp. Histopathological examination exhibited necrosis areas, intense mononuclear inflammatory infiltrate and bulky hyphae, thus concluding the mucormycosis diagnosis. Amphotericin B antifungal therapy and surgical intervention were adopted as treatment. The patient was then rehabilitated with maxillofacial prosthesis, subsequently to the healing of the surgical wound. |
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