Zygomycosis of the Oral Cavity in a Main Referral Centre in Malaysia: A Case Series (1967-2021)
DOI:
https://doi.org/10.22452/adum.vol30no2Keywords:
Zygomycosis, Mucormycosis, Fungal, InfectionAbstract
Zygomycosis is a rare opportunistic fungal infection caused by fungi in the phylum Mucoromycota, subphylum Mucoromycotina and order Mucorales. Immunocompromised patients may harbour the disease by inhalation of the spores from the environment into the paranasal sinuses. Rhino-orbital-cerebral is the most common form which extends into the oral cavity, especially to the palate. We present twelve cases of zygomycosis diagnosed in the Stomatology Unit, Institute for Medical Research (IMR), Malaysia. Most of the patients are immunocompromised and presented as the rhino-orbital-cerebral form. Routine haematoxylin and eosin (H&E) staining were used for all cases while selected cases required additional special staining. The characteristic histological features of broad, non-septate, branched, amphophilic fungal hyphae are seen. We aim to report this rare occurrence to contribute to the literature and raise awareness about this condition among clinicians. To date, this is the first compilation of oral zygomycosis cases known to be reported in Malaysia.
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References
Walther, Wagner, Kurzai. Updates on the Taxonomy of Mucorales with an Emphasis on Clinically Important Taxa. Journal of Fungi. 2019;5(4):106.
Hassan MIA, Voigt K. Pathogenicity patterns of mucormycosis: epidemiology, interaction with immune cells and virulence factors. Medical Mycology. 2019;57(Supplement_2):S245-S56.
Ribes JA, Vanover-Sams CL, Baker DJ. Zygomycetes in Human Disease. Clinical Microbiology Reviews. 2000;13(2):236-301.
Jeong W, Keighley C, Wolfe R, Lee WL, Slavin MA, Kong DCM, et al. The epidemiology and clinical manifestations of mucormycosis: a systematic review and meta-analysis of case reports. Clinical Microbiology and Infection. 2019;25(1):26-34.
McLean FM, Ginsberg LE, Stanton CA. Perineural spread of rhinocerebral mucormycosis. AJNR Am J Neuroradiol. 1996;17(1):114-
Deepa A, Nair BJ, Sivakumar T, Joseph AP. Uncommon opportunistic fungal infections of oral cavity: A review. J Oral Maxillofac Pathol. 2014;18(2):235-43.
Prakash H, Chakrabarti A. Global Epidemiology of Mucormycosis. Journal of Fungi. 2019;5(1):26.
Ng KH, Chin CS, Jalleh RD, Siar CH, Ngui CH, Singaram SP. Nasofacial zygomycosis. Oral Surg Oral Med Oral Pathol. 1991;72(6):685-8.
Fattah SY, Hariri F, Ngui R, Husman SI. Tongue necrosis secondary to mucormycosis in a diabetic patient: A first case report in Malaysia. J Mycol Med. 2018;28(3):519-22.
Guarner J, Brandt ME. Histopathologic diagnosis of fungal infections in the 21st century. Clin Microbiol Rev. 2011;24(2):247-80.
Kwon-Chung KJ. Taxonomy of fungi causing mucormycosis and entomophthoramycosis (zygomycosis) and nomenclature of the disease: molecular mycologic perspectives. Clin Infect Dis. 2012;54 Suppl 1(Suppl 1):S8-s15.
Roden MM, Zaoutis TE, Buchanan WL, Knudsen TA, Sarkisova TA, Schaufele RL, et al. Epidemiology and outcome of zygomycosis: a review of 929 reported cases. Clin Infect Dis. 2005;41(5):634-53.
Department of Statistics M. Population Distribution by Local Authority Areas and Mukims. In: Department of Statistics M, editor. 2010.
Pal R, Singh B, Bhadada SK, Banerjee M, Bhogal RS, Hage N, et al. COVID-19-associated mucormycosis: An updated systematic review of literature. Mycoses. 2021;64(12):1452-9.
Biradar S, Patil SN, Kadeli D. Mucormycosis in a Diabetic Ketoacidosis Patient: A Case Report. J Clin Diagn Res. 2016;10(5):Od09-10.
Vijayabala GS, Annigeri RG, Sudarshan R. Mucormycosis in a diabetic ketoacidosis patient. Asian Pacific Journal of Tropical Biomedicine. 2013;3(10):830-3.
Selvamani M, Donoghue M, Bharani S, Madhushankari GS. Mucormycosis causing maxillary osteomyelitis. J Nat Sci Biol Med. 2015;6(2):456-9.
Shetty SR, Punnya VA. Palatal mucormycosis: a rare clinical dilemma. Oral Surgery. 2008;1(3):145-8.
Auluck A. Maxillary necrosis by mucormycosis. a case report and literature review. Med Oral Patol Oral Cir Bucal. 2007;12(5):E360-4.
Venkatesh D, Dandagi S, Chandrappa PR, Hema KN. Mucormycosis in immunocompetent patient resulting in extensive maxillary sequestration. J Oral Maxillofac Pathol. 2018;22(Suppl 1):S112-S6.
Shetty S, Kini U, Joy R. Isolated lingual mucormycosis in an infant with Down syndrome. Ear Nose Throat J. 2008;87(1):34-5, 43.
Cornely OA, Alastruey-Izquierdo A, Arenz D, Chen SCA, Dannaoui E, Hochhegger B, et al. Global guideline for the diagnosis and management of mucormycosis: an initiative of the European Confederation of Medical Mycology in cooperation with the Mycoses Study Group Education and Research Consortium. The Lancet Infectious Diseases. 2019;19(12):e405-e21.
Troeltzsch M, Knösel T, Eichinger C, Probst F, Troeltzsch M, Woodlock T, et al. Clinicopathologic features of oral squamous cell carcinoma: do they vary in different age groups? J Oral Maxillofac Surg. 2014;72(7):1291-300.
Chung CK, Rahman SM, Lim ML, Constable WC. Squamous cell carcinoma of the hard palate. Int J Radiat Oncol Biol Phys. 1979;5(2):191-6.
Montero PH, Patel SG. Cancer of the Oral Cavity. Surgical Oncology Clinics of North America. 2015;24(3):491-508.
Moore BA, Burkey BB, Netterville JL, Butcher RB, 2nd, Amedee RG. Surgical management of minor salivary gland neoplasms of the palate. Ochsner J. 2008;8(4):172-80.
Senthilnathan N, Rajaram Mohan K, Fenn SM, Pethagounder Thangavelu R. Necrotizing Sialometaplasia: A Diagnostic Challenge to Oral Physicians. Cureus. 2022.
Bast F, Groß A, Hecht L, Schrom T. Etiology and treatment of osteonecrosis of the mandible. Współczesna Onkologia. 2013;3:281-5.
Manjunath NM, Pinto PM. Management of Recurrent Rhinomaxillary Mucormycosis and Nasal Myiasis in an Uncontrolled Diabetic Patient: A Systematic Approach. Int J Appl Basic Med Res. 2018;8(2):122-5.
Douglas AP, Smibert OC, Bajel A, Halliday CL, Lavee O, McMullan B, et al. Consensus guidelines for the diagnosis and management of invasive aspergillosis, 2021. Internal Medicine Journal. 2021;51(S7):143-76.
Kalaskar RR, Kalaskar AR, Ganvir S. Oral mucormycosis in an 18-month-old child: a rare case report with a literature review. J Korean Assoc Oral Maxillofac Surg. 2016;42(2):105-10.
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