2.23.24
Quick Review #112 - #pathology #oralpathology #doctorgallagher #oralsurgery #oralsurgeon #dentist #dentistry #dental #podcast #podcasts #dentalpodcast #dentalpodcasts #doctorgallagherpodcast #doctorgallagherspodcast
Mucormycosis, also known as black fungus, is a rare but severe fungal infection caused by a group of molds known as mucormycetes. It predominantly affects individuals with compromised immune systems, such as those with diabetes mellitus, cancer, organ transplant, or long-term corticosteroid use. Clinicians can recognize mucormycosis through its distinct oral, nasal, and facial manifestations:
Nasal and Sinus Manifestations:
• Nasal Congestion: Initially presenting as common sinusitis symptoms.
• Black Necrotic Lesions: Black or dark-colored spots on the nasal bridge or inside the nasal cavity, indicating necrosis due to fungal invasion.
• Bloody Nasal Discharge: As the disease progresses, there may be bloody discharge from the nose.
Oral Manifestations:
• Palatal Ulceration: Black necrotic ulcers on the hard palate, which may penetrate into the nasal cavity or sinuses, often painless initially.
• Loose Teeth: In advanced cases, teeth within the affected area may become loose without apparent dental cause.
• Sinus tracts: Multiple fistulas and/or sinus tracts may arise on the buccal mucosa, and can be appreciated in the clinical photo shown.
Facial Manifestations:
• Facial Swelling: Edema and swelling on one side of the face, often extending to the eye (periorbital edema).
• Facial Pain: Pain in the affected area of the face, which may be severe and worsen with disease progression.
• Skin Necrosis: Darkening of the facial skin, indicating necrosis, particularly around the nasal and periorbital areas.
Additional Signs and Symptoms:
• Vision Problems: Including blurred vision, double vision, or complete loss of vision, due to orbital involvement.
• Neurological Symptoms: Such as headache, altered mental status, or cranial nerve deficits, indicating intracranial spread.
• Fever: Although not specific, fever may accompany the infection.
References:
1. Garg, P., Sohal, A., & Mittal, S. (2022). Mucormycosis presenting as dental pain. Cleveland Clinic Journal of Medicine, 89(10), 553-555. https://lnkd.in/ehWBvzXt
2. Spellberg, B., Edwards, J., & Ibrahim, A. (2005). Novel perspectives on mucormycosis: pathophysiology, presentation, and management. Clinical Microbiology Reviews, 18(3), 556-569. https://lnkd.in/eDcDv9Mt
3. Petrikkos, G., Skiada, A., Lortholary, O., Roilides, E., Walsh, T. J., & Kontoyiannis, D. P. (2012). Epidemiology and clinical manifestations of mucormycosis. Clinical Infectious Diseases, 54(suppl_1), S23-S34. https://lnkd.in/esE35ZgE
4. ChatGPT. 2024.