Successful Mandibular Mucormycosis Treatment in the Severely Neutropenic Patient

J Oral Maxillofac Surg. 2019 Jun;77(6):1209.e1-1209.e12. doi: 10.1016/j.joms.2019.02.012. Epub 2019 Feb 18.

Abstract

Purpose: Mucormycosis is a rare opportunistic and aggressive deep fungal infection that predominantly affects immunocompromised patients, and its mortality rate has been reported as up to 80%. Typing of the infection is based mainly on clinical and anatomic presentations, with the most common being the rhinocerebral type.

Materials and methods: This report presents 3 patients with cancer who had successful treatment of mandibular mucormycosis. Chemotherapy was administered 13 to 30 days before diagnosis of the infection, resulting in neutropenia in all patients. Each case is thoroughly presented from initial admission through its diagnosis and treatment sequence.

Results: Early surgical ablative treatment and antifungal treatment resulted in the resolution of infection in all patients. Absolute neutrophil count increased 7 to 8 days after surgical debridement.

Conclusions: Bringing patients to the post-neutropenic state tremendously increases their odds for survival.

Publication types

  • Review

MeSH terms

  • Antifungal Agents* / therapeutic use
  • Debridement
  • Humans
  • Immunocompromised Host
  • Mucormycosis* / drug therapy
  • Mucormycosis* / etiology
  • Mucormycosis* / surgery
  • Neutropenia* / complications

Substances

  • Antifungal Agents