Oswal Nitin Prakash, Gadre Pushkar Kiran, Sathe Prachee, Gadre Kiran Shrikrishna
Nitin Prakash Oswal, Sahyadri Hospital, Bopodi, Pune 411003, India.
Case Rep Dent. 2012;2012:257940. doi: 10.1155/2012/257940. Epub 2012 Jun 20.
Mucormycosis is a fulminant fungal infection that occurs most often in diabetic and immunocompromised individuals. Our patient, with uncontrolled diabetes mellitus and multiple systemic disorders, developed postextraction mucormycosis of mandible, an extremely rare complication. An initial clinical and radiographic diagnosis of mandibular osteomyelitis was made and the lesion was treated medically and surgically with curettage and saucerisation. The specimen was sent for histopathological evaluation, which showed necrotic area containing broad aseptate fungal hyphae with right angle branching consistent with mucormycosis. The patient succumbed to multipleorgan failure secondary to septicemia. The disease is usually fatal with a poor survival rate; there is still paucity of literature on the definitive management of this disease involving the mandible. This paper emphasizes the need for correction of underlying immunodeficiency and early diagnosis with aggressive multimodality treatment approach to offer the best chance of survival.
毛霉菌病是一种暴发性真菌感染，最常发生于糖尿病患者和免疫功能低下者。我们的患者患有未得到控制的糖尿病和多种全身性疾病，发生了下颌骨拔牙后毛霉菌病，这是一种极其罕见的并发症。最初临床和影像学诊断为下颌骨骨髓炎，对病变进行了药物治疗以及刮除术和碟形手术治疗。标本送去做组织病理学评估，结果显示坏死区域含有宽的无隔真菌菌丝，呈直角分支，符合毛霉菌病表现。患者因败血症继发多器官衰竭死亡。该病通常致命，生存率低；关于涉及下颌骨的这种疾病的确定性治疗，文献仍然匮乏。本文强调需要纠正潜在的免疫缺陷，并通过积极的多模式治疗方法进行早期诊断，以提供最佳的生存机会。
