Oral involvement in mucormycosis. A retrospective study of 55 cases

Abstract

Introduction: Mucormycosis with oral involvement (OIM) is a rare opportunistic and lethal mycosis, which has increased in the last decade and is generally associated with uncontrolled diabetes and neutropenia.

Methods: A retrospective study of cases with OIM was carried out in a tertiary-care center. Mycological and histological examinations were performed, and the isolated organisms were identified by morphology and molecular biology.

Results: Fifty-five OIM patients were included, with a median age of 38 years (61.8% males). The most frequent associated disease was type-2 diabetes mellitus (61%), followed by neutropenia due to acute lymphocytic leukemia (27%). The main presentation was palatal and mandibular ulcers (92.7%) and, to a lesser extent, gingival and lingual necrosis. The diagnosis was established by mycological and histopathological studies. The most frequent fungi isolated was Rhizopus arrhizus (67.2%).

Conclusion: OIM is a rapidly progressing disease, therefore, an early diagnosis and the proper control of predisposing factors is necessary, and consequently, contributing to improve the outcome of mucormycosis.

Keywords: Diabetes; Mucormicosis; Mucormycosis; Mucosa necrosis; Necrosis de mucosas; Neutropenia; Palatal ulcer; Rhizopus arrhizus; Úlcera palatina.