J Korean Assoc Oral Maxillofac Surg.  2013 Oct;39(5):246-250.

Importance of immediate surgical intervention and antifungal treatment for rhinocerebral mucormycosis: a case report

• Kim JG
• Park HJ
• Park JH
• Baek J
• Kim HJ
• Cha IH
• Nam W

Abstract

Rhinocerebral mucormycosis (RCM) is an opportunistic, potentially life-threatening fungal disease. This infective disease invades not only the facial sinuses, but also the maxilla, zygoma, and rhino-cerebral structures with a massive destruction of the facial skeletons and soft tissue. This disease progresses within various underlying diseases, such as diabetes mellitus, hematologic malignancy, renal failure, and systemic immunodepression. The relationship between mucormycosis and these underlying conditions have been discussed extensively in the literature. The authors studied 6 cases of RCM diagnosed by a tissue biopsy and treated at the department of oral and maxillofacial surgery, from 1997 to 2012. Patients were treated with several kinds of surgical interventions and antifungal agents, and their clinical & radiological signs, underlying conditions, surgical methods, and outcomes were analyzed.

Keyword

Mucormycosis; Diabetes mellitus; Diagnosis

MeSH Terms

Antifungal Agents
Biopsy
Diabetes Mellitus
Hematologic Neoplasms
Humans
Maxilla
Mucormycosis*
Renal Insufficiency
Skeleton
Surgery, Oral
Zygoma
Antifungal Agents

Figure

• 

  Fig. 1 A. Preoperation computed tomography (CT) axial view: presenting involvement of left maxilla, zygoma and severe mucosal thickening on both maxillary sinus. B. Preoperation CT axial view: presenting involvement of maxilla, left maxillary sinus; and increased bony sclerosis in the medullary portion of left maxilla. C. Preoperation CT frontal view: presenting involvement of left maxilla, zygoma, floor of orbit, ethmoidal, sphenoidal sinus, nasal cavity, alveolar bone. Arrows indicate the border of the lesion.

• 

  Fig. 2 Histological view of rhinocerebral mucormycosis. A. Periodic acid-Schiff (PAS) staining, ×200. B. H&E staining, ×200. C. Grocott's methenamine silver (GMS) staining, ×200. Arrows and arrowheads in the figures show aseptate hyphae branching at 90°.

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