Rhino Orbital Mucormycosis Presenting as Palatal Ulcers- a Report of Two Cases

DOI : http://dx.doi.org/10.13005/bpj/652

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Mucormycosis is a life threatening fungal infection caused by fungi of the order Mucorales and is one of the fulminant and fatal opportunistic infections, characterized by very acute onset, with a high mortality rate. Rhinocerebralmucormycosis is the most common type and its extension to the orbit and brain is quite usual. It is commonly reported in immunocompromised patients such as poorly controlled diabetics, immunosuppression with corticosteroids, hematological malignancy, solid malignancy, iron overload and burns. Mucormycosis is on the rise with an increase in incidence of Diabetes mellitus and HIV infection leading to immunocompromised status of the patient. Here in, reporting two cases of rhinocerebralmucormycosis in two diabetic patients with  palatal perforation in  both cases and this is a rare and late occurrence. One was in a known systemic lupus erythematosus (SLE) patient, which is a very rare incidence.   Both the patients were successfully treated with a combination of surgical debridement and systemic amphotericin B administration. By presenting these two case reports we would like to point out that mucormycosis should be included in the differential diagnosis of hard palate ulcers and cellulitis, especially in diabetic patients.

Mucorales;  rhino orbital; subtotal maxillectomy; vascular thrombosis