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A Surgical Approach in the Management of Mucormycosis in Trauma Patients
Karn Singh1, K Jyothirmayee1, Ruma Rani1
1Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Afzalgunj, Hyderabad, Telangana, India.
Introduction:
Fungal infections are rare occurrence in the oral cavity. They are most often seen in other medical conditions such as the immunocompromised states, diabetes, on immunosuppressants, and more recently, among the COVID patients. There are various ways that are employed to manage these infections. The most usual of fungal infection in these conditions is mucormycosis, also called as zygomycosis. Hence, in our study, we aim to evaluate the management of the fungal infection mucormycosis in trauma patients by the surgical approach.
Materials And Methods:
We piloted a retrospective observational study among 50 subjects who were admitted to the department with oral fungal infections with mucormycosis. We analyzed various clinical and demographic parameters among the subjects. The data thus obtained were analyzed with proper statistical tools deliberating P < 0.05 as significant.
Results:
We observed that among the 50 subjects, the mean age was 41 ± 1.7 years. There was no significant difference between the genders and the age groups. The most common reason for the oral involvement was uncontrolled diabetes. This was followed by malignancy, specifically leukemia, AIDS, and COVID. The most common site of the involvement was the palate, followed by the mandibular region. All the subjects tested positive for the fungal hyphae of Rhizopus arrhizus which was the most common of the species. The surgical debridement along with the medical management showed satisfactory results, while one death was noted in our study.
Conclusion:
Although rare, oral involvement in the fungal infection with the mucormycosis is often easily managed when diagnosed early. The proper surgical debridement is the best method of treatment along with the appropriate medications. The management of the underlying medical conditions is the primary key for the success of the treatments.
Insights
Surgical management of oral mucormycosis, a rare fungal infection, shows satisfactory results in trauma patients. Early diagnosis and treatment of underlying conditions like diabetes are crucial for successful outcomes.
Area of Science:
- Oral Medicine
- Infectious Diseases
- Surgical Pathology
Background:
- Oral fungal infections, particularly mucormycosis (zygomycosis), are uncommon but serious.
- These infections often occur in immunocompromised individuals, those with diabetes, on immunosuppressants, or recently affected by COVID-19.
- Mucormycosis requires prompt and effective management strategies.
Purpose of the Study:
- To evaluate the efficacy of surgical management for oral mucormycosis in trauma patients.
- To analyze clinical and demographic factors associated with oral mucormycosis in this cohort.
Main Methods:
- A retrospective observational study was conducted on 50 patients with oral mucormycosis.
- Clinical and demographic data were collected and statistically analyzed (P < 0.05 considered significant).
Main Results:
- The mean age of patients was 41 ± 1.7 years, with no significant gender or age group differences.
- Uncontrolled diabetes was the leading predisposing factor, followed by malignancy (leukemia), AIDS, and COVID-19.
- The palate was the most commonly affected site, with *Rhizopus arrhizus* identified as the predominant fungal species. Surgical debridement combined with medical management yielded satisfactory results, with one mortality.
Conclusions:
- Oral mucormycosis, though rare, is manageable with early diagnosis and appropriate treatment.
- Surgical debridement, alongside medical therapy, is the preferred treatment approach.
- Effective management of underlying medical conditions is paramount for successful treatment outcomes.
