Atypical presentations of fungal osteomyelitis during post COVID-19 outbreak – Case series. Issue 5 (September 2022)

• Record Type: Journal Article
• Authors: Chugh, Ankita; Pandey, Akhilesh Kumar; Goyal, Amit; Soni, Kapil; Jain, Vidhi; Thirunavukkarasu, Balamurugan; Vedant, Deepak; Kumar, Deepak; Kumar, Pravin
• Is Part Of: Journal of oral and maxillofacial surgery, medicine, and pathology. Volume 34:Issue 5(2022)
• Page Start: 622
• Page End: 627
• Publication Date: 2022-09
• Subjects: Fungal osteomyelitis -- Mucormycosis -- Aspergillosis -- COVID-19 -- Antifungal therapy; Mouth -- Surgery -- Periodicals; Face -- Surgery -- Periodicals; Maxilla -- Surgery -- Periodicals; Oral medicine -- Periodicals; Mouth -- Diseases -- Pathogenesis -- Periodicals; Surgery, Oral -- Periodicals; Oral Medicine -- Periodicals; Pathology, Oral -- Periodicals; Face -- Surgery; Maxilla -- Surgery; Mouth -- Diseases -- Pathogenesis; Mouth -- Surgery; Oral medicine; Electronic journals -- Sciences; Electronic journals -- Medicine; Periodicals; 617.522059
• DOI: 10.1016/j.ajoms.2022.03.007
• Languages: English
• ISSNs: 2212-5566

Abstract

Abstract: Introduction: Mucormycosis and Aspergillosis are opportunistic fungal infections causing significant morbidity and mortality. Post the outbreak of COVID-19, these fungal osteomyelitis have seen a global rise with few atypical presentations noted. Case report: Current case series reports three such atypical presentations of fungal osteomyelitis including mandibular fungal osteomyelitis in two patients, fungal osteomyelitis mimicking space infection in a middle aged male, and suspected mixed fungal osteomyelitis involving maxillary sinus. Aggressive surgical debridement was indicated along with institution of antifungal therapy (Liposomal Amphotericin B, and Posaconazole). The fungal osteomyelitis was successfully treated with surgical and medical management with no recurrence. Discussion: The injudicious use of corticosteroids in COVID-19 patients along with their immunocompromised status increases their susceptibility to opportunistic fungal osteomyelitis. Prompt and aggressive surgical intervention along with antifungal therapy is important after diagnosing fungal osteomyelitis, as a delay could increase the mortality rate considerably.