Case Report on Mucormycotic Osteomyelitis of Maxilla

Abstract

Introduction: The upper jaw is formed by the maxilla, one of the basic bones of the face. It is a crucial viscerocranium structure that aids in the creation of the palate, nose, and orbit. The upper teeth are held in place by the alveolar process of the maxilla, which is vital for mastication and speaking. Because of its substantial vascular supply, maxillary necrosis is uncommon compared to mandible necrosis [1]. Maxillary necrosis can be caused by bacterial infections like osteomyelitis, viral infections like herpes zoster, or fungal infections like mucormycosis, as well as trauma, radiation, and other factors [2]. Long-term use of antibiotics or corticosteroids, on the other hand, may result in an opportunistic infection. Mucormycosis is a fungal infection that mostly affects immunocompromised persons. These fungi are widespread in many people, although the symptoms have been linked to a weakened immune system. Mucormycosis is a life-threatening illness that frequently affects immunocompromised individuals due to diabetic ketoacidosis, neutropenia, organ transplantation, and elevated blood iron levels. Clinical Findings: The patient have a complaint of discomfort in the upper left side of the jaw was rapid in start, dull hurting, intermittent in character, and worse on mastication. A radiating headache on the left side is also a complaint. Diagnostic Evaluation: CRP - 12.48 m/ L, Calcium 8.1 mg/dl, KFT-Ser (urea – 29 mg/dl, Creatinine 0.4 mg/dl, Sodium 138 mmol/L, Potassium -4.3 mmol/L, Albumin 2.6 g/dl,) Urine exam routine Pus cells 1-2 cells, urine albumin nil, Crystal 3-4 calcium oxalate Crystal, 2D echo was done on dated 31/5/21, MRI was done,  Cardiac call was done. Therapeutic Intervention: If not recognised and treated early, fungal osteomyelitis is more invasive than bacterial osteomyelitis. Treatment is given to the patient as a follow-up. Debridement of necrotic tissue on a local level. Antibiotics - Tab Augmentine 625 mg, Tab paracetamols 500 mg, Inj T. T 0.5 ml in a single dosage, Antifungal treatment, and Betadine gargle twice a day. Conclusion: On 04/06/2021, a 58-year-old male was hospitalised to AVBR Hospital's Oral Surgery Ward 35 after being diagnosed with Mucormycotic Osteomyelitis of the Maxilla. The patient is being counselled on how to proceed with his treatment.