“What are Key Oral & Facial Manifestations of Mucormycosis?”

2.23.24 Quick Review #112 - #pathology #oralpathology #doctorgallagher #oralsurgery #oralsurgeon #dentist #dentistry #dental #podcast #podcasts #dentalpodcast #dentalpodcasts #doctorgallagherpodcast #doctorgallagherspodcast Mucormycosis, also known as black fungus, is a rare but severe fungal infection caused by a group of molds known as mucormycetes. It predominantly affects individuals with compromised immune systems, such as those with diabetes mellitus, cancer, organ transplant, or long-term corticosteroid use. Clinicians can recognize mucormycosis through its distinct oral, nasal, and facial manifestations: Nasal and Sinus Manifestations: • Nasal Congestion: Initially presenting as common sinusitis symptoms. • Black Necrotic Lesions: Black or dark-colored spots on the nasal bridge or inside the nasal cavity, indicating necrosis due to fungal invasion. • Bloody Nasal Discharge: As the disease progresses, there may be bloody discharge from the nose. Oral Manifestations: • Palatal Ulceration: Black necrotic ulcers on the hard palate, which may penetrate into the nasal cavity or sinuses, often painless initially. • Loose Teeth: In advanced cases, teeth within the affected area may become loose without apparent dental cause. • Sinus tracts: Multiple fistulas and/or sinus tracts may arise on the buccal mucosa, and can be appreciated in the clinical photo shown. Facial Manifestations: • Facial Swelling: Edema and swelling on one side of the face, often extending to the eye (periorbital edema). • Facial Pain: Pain in the affected area of the face, which may be severe and worsen with disease progression. • Skin Necrosis: Darkening of the facial skin, indicating necrosis, particularly around the nasal and periorbital areas. Additional Signs and Symptoms: • Vision Problems: Including blurred vision, double vision, or complete loss of vision, due to orbital involvement. • Neurological Symptoms: Such as headache, altered mental status, or cranial nerve deficits, indicating intracranial spread. • Fever: Although not specific, fever may accompany the infection. References: 1. Garg, P., Sohal, A., & Mittal, S. (2022). Mucormycosis presenting as dental pain. Cleveland Clinic Journal of Medicine, 89(10), 553-555. https://lnkd.in/ehWBvzXt 2. Spellberg, B., Edwards, J., & Ibrahim, A. (2005). Novel perspectives on mucormycosis: pathophysiology, presentation, and management. Clinical Microbiology Reviews, 18(3), 556-569. https://lnkd.in/eDcDv9Mt 3. Petrikkos, G., Skiada, A., Lortholary, O., Roilides, E., Walsh, T. J., & Kontoyiannis, D. P. (2012). Epidemiology and clinical manifestations of mucormycosis. Clinical Infectious Diseases, 54(suppl_1), S23-S34. https://lnkd.in/esE35ZgE 4. ChatGPT. 2024.