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Progress in Medical Sciences ISSN: 2577 - 2996

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Progress in Medical Sciences. 2022; 6(2):(77-112)

Infection of Aspergillous and Mucormycosis in Maxillary Region of a Woman with Diabetes After Covid19, A Case Report

Yeganeh Arian

Introduction: COVID as a common pandemic respiratory disease has affected many people in the world today. Symptoms of the disease include fever, cough, fatigue and lethargy, shortness of breath, lack of sense of smell and taste, etc. In people with weakened immune systems, especially if they have received corticosteroids, it can cause fungal diseases, especially with two types of aspergillus and mucormycosis, which can cause sinusitis, endocarditis, osteomyelitis and even death. One of the symptoms of this disease in the maxillofacial region is extensive osteomyelitis with sequestration and mobility of the teeth and pus drainage in the maxilla and palatal region. Which can be controlled with proper surgical treatment and medication. 

Case Presentation: The patient was a 36-year-old woman with a history of uncontrolled diabetes mellitus who developed Covid 19, 5 months ago. And after a month of taking corticosteroids, she suffered from severe pain and swelling, along with necrosis and secretion of pus and loose teeth in the alveolar, palatal, and part of the masculine butters. Simultaneous presence of Aspergillus and Mucormycosis was reported after sampling and culture. Immediately after controlling the patient's glycemia and initiating Amphotericin and Clindamycin at the same time, the patient underwent infrastructural maxillectomy, including removal of the bone and mucosa of the alveolar, palatal region, part of the maxillary buttress on both sides, nasal septum, nasal floor, nasal mucosa and sinuses along the walls. Both sinuses were anteriorly, laterally, debridement, curettage, and washed with amphotericin. Injection of amphotericin continued for up to two months, and after two endoscopic biopsies and negative margins, both drugs were discontinued. And the patient is controlling for follow-up. 

Conclusion: Due to the fatal fungal infection of Mucormycosis and Aspergillus and the extensive involvement of the maxilla, prompt and extensive treatment can effectively help improve the disease. And long-term follow-up and control of the patient's sugar accelerates the healing process.