PDF(Pubmed)
Abstract：
The opportunistic infection of post-Covid associated mucormycosis has been reported globally; however, it has reached alarming proportions in India. Mucormycosis of the mandibular region is rare, and only a few cases have been reported to date. Covid associated mucormycosis has not been reported in the literature before, and we are the first to report them. We report two patients who presented with tooth loosening with pus discharge a few weeks following recovery from Covid infection. After tooth extraction adjacent necrotic bony specimen was sent for calcofluor potassium hydroxide mount, which was found positive for broad pauciseptate hyphae. Although CT scan imaging demonstrated the involvement of a mandible segment, we found a much more extensive involvement in both cases during resection. There was intramedullary spread of the mucormycosis throughout the inferior alveolar canal, with pus discharge and foul odor. The management of covid associated mandibular mucormycosis consists of surgical debridement with antifungal therapy and control of the underlying disease. It became challenging because the radiological extent of the disease was different from the definite clinical extension of the lesion found during surgery. The authors recommend surgeons adopt a flexible approach during surgery to plan resection depending on the clinical judgment and not rely entirely on CT scans. And the reconstruction of the mandible will follow as per the extent of excision.
摘要：
已经在全球范围内报道了Covid后相关毛霉菌病的机会性感染；然而，在印度已经达到了惊人的程度。下颌区域的毛霉菌病很少见，到目前为止只报告了几例。Covid相关的毛霉菌病以前在文献中没有报道，我们是第一个报告他们的。我们报告了两名患者，他们在Covid感染恢复后几周出现牙齿松动，脓液排出。拔牙后，将邻近的坏死骨标本送去calcofluor氢氧化钾安装，发现广泛的pauciseptate菌丝呈阳性。尽管CT扫描成像显示下颌骨段受累，我们发现两种病例在切除过程中都有更广泛的参与.毛霉菌病在整个下牙槽管有髓内扩散，有脓液和恶臭。covid相关的下颌毛霉菌病的治疗包括手术清创和抗真菌治疗以及对潜在疾病的控制。这变得具有挑战性，因为该疾病的放射学范围与手术期间发现的病变的明确临床扩展不同。作者建议外科医生在手术期间根据临床判断采取灵活的方法来计划切除，而不是完全依靠CT扫描。下颌骨的重建将根据切除的程度进行。
