Odontogenic-onset mucormycosis: A case series from a tertiary care institute in North India

Author: mycolabadmin
9/11/2025
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Summary

This case series describes five patients from India who developed a serious fungal infection in their jaw and mouth after dental procedures. All patients had uncontrolled diabetes, which weakened their immune system and allowed the fungus to grow. The infection was treated with anti-fungal medications and surgery, and most patients recovered well. The study emphasizes the importance of keeping dental equipment sterile and managing blood sugar levels properly before dental work.

Background

Mucormycosis is an aggressive angio-invasive fungal infection affecting immunocompromised individuals, with India reporting 80 times higher incidence than global average. While rhino-orbital-cerebral mucormycosis (ROCM) is the most common form, odontogenic-onset mucormycosis (OOM) has emerged as a distinct clinical entity characterized by dental symptoms following dental procedures with predominant alveolar bone involvement and limited sinus disease.

Objective

To describe and analyze a series of five cases of odontogenic-onset mucormycosis managed at a tertiary care center in North India, highlighting clinical presentation, diagnostic features, and management challenges. The study aims to increase awareness among dental practitioners about this emerging entity and emphasize the importance of aseptic precautions during dental procedures.

Results

Five cases of OOM were identified, developing 2-6 weeks following dental procedures (tooth extraction or root canal therapy). All patients had uncontrolled/poorly controlled diabetes except one with controlled diabetes. Imaging revealed osteolytic lesions in the alveolar-basal region with minimal sinus involvement. All cases were confirmed by histopathology showing broad aseptate fungal hyphae with angioinvasion. Treatment involved surgical debridement combined with liposomal amphotericin B followed by oral posaconazole, with favorable outcomes and minimal orbital/cerebral complications.

Conclusion

Odontogenic-onset mucormycosis represents a distinct clinical entity requiring high index of suspicion for early diagnosis and intervention. Dental professionals must maintain strict aseptic precautions and ensure glycemic control before elective procedures. The series emphasizes the need for clear differentiation between OOM and ROCM for prompt recognition and targeted preventive strategies.

Published in:Medical Mycology Case Reports,
Study Type:Case Series,
Source: PMID: 41017794, DOI: 10.1016/j.mmcr.2025.100730