Rhinocerebral mucormycosis: a systematic review of case reports and case series from a global perspective

Mathangi Kumar; Ragavi Alagarsamy; Medhini Madi; Kalyana Chakravarthy Pentapati; Ravindranath Vineetha; Shishir Ram Shetty; Ankita Sharma

doi:10.1016/j.oooo.2022.06.006

Rhinocerebral mucormycosis: a systematic review of case reports and case series from a global perspective

Oral Surg Oral Med Oral Pathol Oral Radiol. 2022 Dec;134(6):708-716. doi: 10.1016/j.oooo.2022.06.006. Epub 2022 Jun 18.

Authors

Mathangi Kumar¹, Ragavi Alagarsamy², Medhini Madi³, Kalyana Chakravarthy Pentapati⁴, Ravindranath Vineetha¹, Shishir Ram Shetty⁵, Ankita Sharma⁶

Affiliations

¹ Department of Oral Medicine & Radiology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India.
² Department of Burns, Plastic and Maxillofacial Surgery, VMMC and Safdarjung Hospital, New Delhi, India.
³ Department of Oral Medicine & Radiology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India. Electronic address: medhini.madi@gmail.com.
⁴ Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India.
⁵ Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, United Arab Emirates.
⁶ Royal Clinic, Pontiac, MI, USA.

PMID: 36184407
DOI: 10.1016/j.oooo.2022.06.006

Abstract

Objective: Rhinocerebral mucormycosis (RCM) is the most common variant and the presenting features in the head and neck region are seldom pathognomonic. The aim of this systematic review was to obtain a thorough insight into the predisposing factors, clinical features, disease course, management protocol, outcome, and prognosis.

Study design: An electronic search was carried out using MEDLINE by PubMed, Scopus, Google Scholar, Web of Science, and EMBASE databases. Articles in which the clinical findings on the extra- and intraoral features of RCM were included for systematic review. Descriptive statistics was applied to obtain the results.

Results: A total of 124 case studies (90 case reports, 34 case series) which yielded 219 patients. Diabetes mellitus (57.40%) was the most common comorbid condition. Neurologic manifestations were noted in 23.3% of the individuals. Maxillary/hard palate involvement was a common occurrence (59.2%). Intra-oral necrotic lesions with eschar were noted in 75/219 patients. Amphotericin B was the commonly used drug for the management, and surgical debridement was performed in majority of the cases. The mortality rate was 18.4%.

Conclusions: The clinical manifestations often mimic odontogenic symptoms, hence a sound knowledge about the pathogenesis and course of the disease will aid in the prompt diagnosis and management.

Publication types

Review