Dental and Medical Problems

Dent Med Probl
Index Copernicus (ICV 2020) – 128.41
MEiN – 70 pts
CiteScore (2021) – 2.0
JCI – 0.22
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ISSN 1644-387X (print)
ISSN 2300-9020 (online)
Periodicity – quarterly

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Dental and Medical Problems

2016, vol. 53, nr 4, October-December, p. 536–541

doi: 10.17219/dmp/64144

Publication type: review article

Language: English

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Creative Commons BY-NC-ND 3.0 Open Access

Rhinocerebral Mucormycosis: Clinical Outcome, Diagnosis, Treatment – Review of the Literature

Mukormykoza nosowo-mózgowa: obraz kliniczny, diagnostyka, leczenie – przegląd piśmiennictwa

Sylwia Hnitecka1,D,E,F, Kamil Nelke2,D,E,F

1 Student Research Group, Department of Maxillo-Facial Surgery, Wroclaw Medical University, Wrocław, Poland

2 Department of Maxillo-Facial Surgery, Wroclaw Medical University, Wrocław, Poland

Abstract

Many pathogens present in the human environment, in immunocompromised patients, can cause extremely severe opportunistic infections. Most patients suffering from immunological disorders are rarely treated at maxillo-facial departments. In some special cases they require a direct clinical approach. Fungal infections in the cranio-facial area do not occur often, as opposed to infections from bacterial flora which are most frequently found. Some special conditions and requirements are needed to be present for the occurrence of fungal infections. If found, many of them are treated locally by antifungal medicaments, while a few of them require additional radical surgical excisional approach. Mucor sp. is one of these infections and it is related with mucormycosis (zygomycosis). Rhinocerebral zygomycosis is particularly dangerous. This rare cranio-facial infection is a great challenge for all clinicians and surgeons. It seems that only an accurate and proper diagnosis has an impact on the patient’s survival and post-treatment quality of life. In this paper we focus on recent clinical findings and treatment methods of this disease.

Key words

fungal infections, mucormycosis, zygomycosis, rhinocerebral mucormycosis

Słowa kluczowe

infekcje grzybicze, mukormykoza, zygomykoza, mukormykoza nosowo-mózgowa

References (31)

  1. Wesołowska M., Gąsiorowski J., Jankowski S.: The opportunistic protozoa in immunocompromised individuals. Adv. Clin. Exp. Med. 2005, 14, 349–355 [in Polish].
  2. Holmes C.B., Losina E., Walensky R.P., Yazdanpanah Y., Freedberg K.A.: Review of human immunodeficiency virus type 1 – related opportunistic infections in Sub-Saharan Africa. Clin. Infect. Dis. 2003, 36, 652–662.
  3. Jatinder N.K., Srivalli N., Jyotsna G.: Rhinocerebral mucormycosis – an emerging threat. J. Oral Maxillofac. Surg. Med. Pathol. 2015, 27, 550–557.
  4. Pajpani M., Webb R.: Lingual necrosis caused by mucormycosis in a patient with aplastic anaemia: Case report. Br. J. Oral Maxillofac. Surg. 2014, 52, 144–146.
  5. Lador N., Polacheck I., Gural A., Sanatski E., Garfunkel A.: A trifungal infection of the mandible: Case report and literature review. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod. 2006, 101, 451–456.
  6. Zborowska-Skrobanek J., Misiuk-Hojło M.: Orbital infections – interdisciplinary problem of ophthalmologists, laryngologists and maxillofacial surgeons. Dent. Med. Probl. 2007, 44, 373–376 [in Polish].
  7. Mignogna M.D., Fortuna G., Leuci S., Adamo D., Ruoppo E., Siano M., Mariani U.: Mucormycosis in immunocompetent patients: A case-series of patients with maxillary sinus involvement and a critical review of the literature. Int. J. Infect. Dis. 2011, 15, 533–540.
  8. Fogarty C., Regennitter F., Viozzi C.F.: Invasive fungal infection of the maxilla following dental extractions in a patient with chronic obstructive pulmonary disease. J. Can. Dent. Assoc. 2006, 72, 149–152.
  9. Bonifaz A., Macias B., Paredes-Farrera F., Arias P., Ponce R.M., Araiza J.: Palatal zygomycosis: Experience of 21 cases. Oral Dis. 2008, 14, 569–574.
  10. Selvamani M., Donoghue M., Bharani S., Madhushankari G.S.: Mucormycosis causing maxillary osteomyelitis. J. Nat. Sc. Biol. Med. 2015, 6, 456–459.
  11. Vaezi A., Moazeni M., Rahimi M.T., de Hoog S., Badali H.: Mucormycosis in Iran: A systematic review. Mycoses, 2016, 59, 402–415.
  12. Katragkou A., Walsh T.J., Roilides E.: Why is mucormycosis more difficult to cure than more common mycoses? Clin. Microbiol. Infect. 2014, 20, 74–81.
  13. Roden M.M., Zaoutis T.E., Buchanan W.L., Knudsen T.A., Sarkisova T.A., Schaufele R.L., Sein M., Sein T., Chiou C.C., Chu J.H., Kontoyiannis D.P., Walsh T.J.: Epidemiology and outcome of zygomycosis: A review of 929 reported cases. Clin. Infect. Dis. 2005, 41, 634–653.
  14. Skiada A., Pagano L., Groll A., Zimmerli S., Dupont B., Lagrou K., Lass-Florl C., Bouza E., Klimko N., Gaustad P., Richardson M., Hamal P., Akova M., Meis J.F., Rodriguez-Tudela J.L., Roilides E., MitrousiaZiouva A., Petrikkos G.: Zygomycosis in Europe: Analysis of 230 cases accrued by the registry of the European Confederation of Medical Mycology (ECMM) Working Group on zygomycosis between 2005 and 2007. Clin. Microbiol. Infect. 2011, 17, 1859–1867.
  15. Casqueiro J., Casqueiro J., Alves C.: Infections in patients with diabetes mellitus: A review of pathogenesis. Indian J. Endocrinol. Metab. 2012, 16, 27–36.
  16. González Ballester D., González-García R., Moreno García C., Ruiz-Laza L., Monje Gil F.: Mucormycosis of the head and neck: Report of five cases with different presentations. J. Craniomaxillofacial Surg. 2012, 40, 584–591.
  17. Trief D., Gray S.T., Jakobiec F.A., Durand M.L., Fay A., Freitag S.K., Lee N.G., Lefebvre D.R., Holbrook E., Bleier B., Sadow P., Rashid A., Chhabra N., Yoon M.K.: Invasive fungal disease of the sinus and orbit: A comparison between mucormycosis and Aspergillus. Br. J. Ophthalmol. 2016, 100, 184–188.
  18. Dzierżanowska D., Gil L., Jakubas B., Kyrcz-Krzemień S., Styczyński J.: Epidemiology and microbiologic diagnostics of invasive fungal disease. Post. Nauk. Med. 2015, 28, 6, 403–409.
  19. Kursun E., Turunc T., Demiroglu Y.Z., Alışkan H.E., Arslan A.H.: Evaluation of 28 cases of mucormycosis. Mycoses, 2015, 58, 82–87.
  20. Mantadakis E., Samonis G.: Clinical presentation of zygomycosis. Clin. Microbiol. Infect. 2009, 15, 15–20.
  21. Samaranayake L.P., Keung Leung W., Jin L.: Oral mucosal fungal infections. Periodontol. 2000, 2009, 49, 39–59.
  22. Hanson K.E., Caligiuri P., Wiggins R.H., Quigley E.P., Kendall B.: Radiologic imaging techniques for the diagnosis and management of invasive fungal disease. Curr. Fung. Infect. Rep. 2015, 9, 180–189.
  23. Metzen D., Böhm H., Zimmermann M., Reuther T., Kübler A.C., Müller-Richter U.D.A.: Mucormycosis of the head and neck. J. Craniomaxillofac. Surg. 2012, 40, 321–327.
  24. Vijayabala G.S., Annigeri R.G., Sudarshan R.: Mucormycosis in a diabetic ketoacidosis patient. Asian Pac. J. Trop. Biomed. 2013, 3, 830–833.
  25. Leitner C., Hoffmann J., Zerfowski M., Reinert S.: Mucormycosis: Necrotizing soft tissue lesion of the face. J. Oral Maxillofac. Surg. 2003, 61, 1354–1358.
  26. Prabhu R.M., Patel R.: Mucormycosis and entomophthoramycosis: A review of the clinical manifestations, diagnosis and treatment. Clin. Microbiol. Infect. 2004, 10 (Suppl. 1), 31–47.
  27. Arndt S., Aschendorff A., Echternach M., Daemmrich T.D., Maier W.: Rhino-orbital-cerebral mucormycosis and aspergillosis: Differential diagnosis and treatment. Eur. Arch. Otorhinolaryngol. 2009, 266, 71–76.
  28. Kurnatowski P.: Pharmacological treatment of fungal sinusitis. Otorynolaryngol. 2010, 9, 13–17.
  29. Ogawa T., Takezawa K., Tojima I., Shibayama M., Kouzaki H., Ishida M., Okabe H., Shimizu T.: Successful treatment of rhino-orbital mucormycosis by a new combination therapy with liposomal amphotericin B and micafungin. Auris Nasus Larynx, 2012, 39, 224–228.
  30. Reed C., Bryan R., Ibrahim A.S., Edwards J., Filler S.G., Goldberg R., Spellberg B.: Combination polyenecaspofungin treatment of rhino-orbital-cerebral mucormycosis. Clin. Infect. Dis. 2008, 47, 364–371.
  31. Walker R.C., Zeuli J.D., Temesgen Z.: Isavuconazonium sulfate for the treatment of fungal infection. Drugs Today, 2016, 52, 7–16.