Successful Mandibular MucormycosisTreatment in the Severe Neutropenic Patient

Publication date: Available online 18 February 2019

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Adir Cohen, Fady Louis Shoukair, Maya Korem, Adir Shaulov, Nardy Casap

Abstract

Mucormycosis is a rare opportunistic and aggressive deep fungal infection that predominantly affects immunocompromised patients and its mortality rate has been reported to be up to 80%.

Typing of the infection is based mainly on the clinical and anatomical presentation, the most common being rhino-cerebral type.

We present three cases of oncology patients who had successful treatment of mandibular mucormycosis. Chemotherapy was administered 13-30 days prior to diagnosis of the infection, resulting in neutropenia in all patients. Each case is thoroughly presented from initial admission through its diagnosis and treatment sequence.

Early surgical ablative treatment along with anti-fungal treatment resulted in the resolution of infection in all patients. Absolute neutrophil count increased 7-8 days after the surgical debridement. We found that if we could bring patients to the post-neutropenic state, the patient odds for survival would increase tremendously.

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