Comorbidity and Mortality Associated With Rhinomaxillary Fungal Osteomyelitis: A Retrospective Study

Fungal infections mostly affect immunocompromised individuals whose immune system lacks the ability to mitigate the fungi. In most cases, unless surgery and antifungal therapy are administered promptly, the condition deteriorates rapidly leading to death. The present retrospective study aims to find out the incidence and type of fungal moulds in the infection affecting the nasomaxillary complex and correlate its comorbidity and mortality associated with it.

This retrospective study was conducted in a tertiary care referral center from January 2022 to December 2023 after obtaining necessary approval from the institutional ethical committee. Patients from both the sex in all age group with histopathologically proven fungal infection of nasomaxillary complex were included in the study.

Total there were 23 cases of which 16 were males and 7 were females. There were 4 deaths and 19 patients recovered from the disease. Of the 4 deaths, 2 patients were treated with total maxillectomy with orbital exenteration, 1 patient treated with hemimaxillectomy with debridement of sinuses and 1 with total maxillectomy. The associated comorbidities were diabetes mellitus (DM) in 14 cases, DM with hypertension (HTN) in 3 cases and chronic kidney disease (CKD) with DM and HTN in 6 cases.

In our study it was observed that all the 23 patients with fungal infections had associated comorbidities. Multiple comorbidities were observed in 4 cases of death. So, an inference can be made that the patients with rhinomaxillary fungal infections are mostly associated with comorbidities.

In all the cases, fungal infection was associated with comorbidities namely DM, HTN, and CKD. This strengthens the fact that in medically compromised patients, mucormycosis spreads faster, causes extensive tissue involvement, and higher fatality as compared with other fungal elements like Aspergillus or Candidal species.