Covid-19-related mucormycotic osteomyelitis of the maxilla: A case report of findings, surgical management and post-surgical rehabilitation

ABSTRACT

Aim and objective: To report a case of surgical management and postsurgical rehabilitation COVID-19-related mucormycotic osteomyelitis of the maxilla. Background: Patients with the SARS-CoV-2 infection, also termed the COVID-19 illness, have been found to be afflicted with other associated bacterial and fungal diseases which have been termed as co-infections. In this regard, mucormycosis, a fungal infection, has been found to occur in these patients especially with a lowered immune response and has been found to cause osteomyelitis of the jaw bones. Case description We present a case of mucormycosis in a COVID-19-affected patient that occurred in August 2020 denoted the first wave of disease in India, causing extensive osteomyelitis of the left maxilla. The patient presented clinically with odontalgia and tooth mobility in the upper anterior region. Clinical examination revealed the presence of abscesses in the attached gingiva in relation to tooth numbers 13,12, 11, 22, 23,24 and 25. A deep horizontal cleft was observed in the mucogingival junction in relation to 23 discharging pus. Computed tomography (CT) imaging revealed a diffuse radiolucency extending from the alveolar ridge of the upper anterior teeth to the left maxillary sinus, breaking the floor of the sinus. We have performed extensive medical and surgical management of this patient including postoperative prosthetic rehabilitation which is documented in the present case report. Clinical significance: Our observation of maxillary osteomyelitis secondary to mucormycosis in the first COVID wave in India makes our case extremely rare and important as this highlights that COVID-19 complications were significant but under-evaluated in the first wave of the disease. © Jaypee Brothers Medical Publishers. 2021.