上顎骨壊死を契機に発見された鼻脳型ムコール症の1例

Abstract

R hinocerebral mucormycosis generally occurs in immunosuppressive conditions such as uncontrolled diabetes mellitus and steroid therapy, and presents acute and aggressive clinical symptoms. Therapeutic strategies for rhinocerebral mucormycosis consist of control of the original immunosuppressive disease, surgery and medication. The prognosis of this condition depends on early diagnosis and treatment. Rhinocerebral mucormycosis rarely presents initial symptoms in the oral cavity. We experienced a case in which rhinocerebral mucormycosis was detected via maxillary osteonecrosis. We played a central role in providing treatment and saving the patient' s life, and his quality of life (QOL) was maintained. The patient was a 62-year-old man who visited our department with severe pain in the left upper molar region. His medical history included rectal cancer with metastatic lung cancer, type 2 diabetes, and coronary spastic angina. Gingival necrosis and sequestrums were observed in the left upper molar region seven days after his first visit. The diagnosis of mucormycosis was made based on micro-fungal biological and pathological samples. Following discussion with related clinical departments, we performed oral surgery twice and a physician provided medication via an antifungal drug. The patient recovered well following treatment. He has returned to work and has been maintaining his QOL over two years under routine follow-up.