Atypical presentations of fungal osteomyelitis during post COVID-19 outbreak - Case series

Area of Science:

• Mycology
• Infectious Diseases
• Oral and Maxillofacial Surgery

Background:

• Opportunistic fungal infections like mucormycosis and aspergillosis pose significant health risks.
• A global increase in fungal osteomyelitis has been observed following the COVID-19 pandemic.
• Atypical presentations of fungal osteomyelitis require careful diagnostic consideration.

Observation:

• This case series details three atypical fungal osteomyelitis cases: mandibular, space infection mimic, and maxillary sinus involvement.
• Two patients presented with mandibular fungal osteomyelitis.
• One middle-aged male exhibited fungal osteomyelitis mimicking a space infection, and another case involved suspected mixed fungal osteomyelitis in the maxillary sinus.

Findings:

• Aggressive surgical debridement combined with antifungal therapy (Liposomal Amphotericin B, Posaconazole) was the primary treatment approach.
• All reported cases of fungal osteomyelitis achieved successful treatment outcomes.
• No recurrence of fungal osteomyelitis was observed post-treatment in the managed cases.

Implications:

• COVID-19 patients, particularly those on corticosteroids, are more susceptible to opportunistic fungal osteomyelitis due to their immunocompromised state.
• Prompt diagnosis and aggressive surgical intervention are critical for managing fungal osteomyelitis.
• Delayed treatment of fungal osteomyelitis can significantly increase mortality rates, underscoring the need for timely and effective management strategies.