IADR Abstract Archives
Oro-facial manifestations of rhino-orbito-cerebral mucormycosis: A case report and a systemic revue of the literature
Objectives: Through a case report and a systemic review , we aimed to highlight the oro-facial manifestations of rhino-orbito-crebral mucormycosis from epidemiological, clinical and radiological aspects.
Methods: Clinical report: A 49-year-old uncontrolled diabetic female patient, presented to our department complaining of pain and swelling in the left cheek and eye for 20 days associated to an acute maxillary osteomyelitis. Histopathological and mycological examination has confirmed the diagnosis of mucormycosis which was managed with systemic antifungals and surgical debridement. Systemic revue: The bibliographic search was conducted on the database “MEDLINE”, via its interface “PUBMED” from 01/01/1995 to 31/05/2017 using “MESH” key words: “mucormycosis”, “maxillary sinus”, “oral manifestations”, “maxillary sinusitis”, “dental prosthesis”, “cellulitis”, “face”, “palate”.
Types of publications included :
Case reports: 28
Case series: 3
Retrospective study: 7
Prospective studies: 3
systematic review of the literature : 2
Results: Two hundreds and thirty five articles were found, after the deletion of the duplicates, filter activation and respect of the inclusion and exclusion criteria, 43 articles [L1] have been included in the review. At an early stage the clinical course is dominated by general signs, an hemifacial swelling associated with edema of the lower eyelid and progressive palatine involvement: eschar, ulceration, bone exposure. The late stage is marked by orbital and cerebral extension. The radiological aspect was unilateral maxillo-ethmoidal sinusitis (49%) associated, at an advanced stage, with bone lysis of the maxillary sinus walls (94%).
Conclusions: Symptoms of ORC mucormycosis are often non specific, complicating early diagnosis. In a patient presenting with facial pain, facial and periorbital oedema, orbital or facial cellulitis and cavernous sinus thrombosis caused by bacterial pathogens must be excluded. Mucormycosis deserve careful investigations, particularly in immunocompromised patients.
Methods: Clinical report: A 49-year-old uncontrolled diabetic female patient, presented to our department complaining of pain and swelling in the left cheek and eye for 20 days associated to an acute maxillary osteomyelitis. Histopathological and mycological examination has confirmed the diagnosis of mucormycosis which was managed with systemic antifungals and surgical debridement. Systemic revue: The bibliographic search was conducted on the database “MEDLINE”, via its interface “PUBMED” from 01/01/1995 to 31/05/2017 using “MESH” key words: “mucormycosis”, “maxillary sinus”, “oral manifestations”, “maxillary sinusitis”, “dental prosthesis”, “cellulitis”, “face”, “palate”.
Types of publications included :
Case reports: 28
Case series: 3
Retrospective study: 7
Prospective studies: 3
systematic review of the literature : 2
Results: Two hundreds and thirty five articles were found, after the deletion of the duplicates, filter activation and respect of the inclusion and exclusion criteria, 43 articles [L1] have been included in the review. At an early stage the clinical course is dominated by general signs, an hemifacial swelling associated with edema of the lower eyelid and progressive palatine involvement: eschar, ulceration, bone exposure. The late stage is marked by orbital and cerebral extension. The radiological aspect was unilateral maxillo-ethmoidal sinusitis (49%) associated, at an advanced stage, with bone lysis of the maxillary sinus walls (94%).
Conclusions: Symptoms of ORC mucormycosis are often non specific, complicating early diagnosis. In a patient presenting with facial pain, facial and periorbital oedema, orbital or facial cellulitis and cavernous sinus thrombosis caused by bacterial pathogens must be excluded. Mucormycosis deserve careful investigations, particularly in immunocompromised patients.