Breaking the Chain in Therapy of Mucormycosis

Background: Mucormycosis is a life-threatening fungal disease that occurs in immunocompromised patients. However, treating the disease without reaching the depth of its pathogenesis wavers one from establishing the effectiveness of said treatment. We present two cases of patients with maxillary mucormycosis with diabetes mellitus as comorbidity, where we studied the role of iron as a benefactor to the progression of the disease and was treated with aggressive surgical management and antifungal drug. Method: In both cases, patients were put on empirical antibiotics. Incisional biopsy was performed. Glycemic Control was achieved and later Surgical intervention in form of sequestromy (Case 1) and partial maxillectomy (Case 2) was performed. Result: For both cases healing occurred with neovascularization. Conclusion: High mortality rates despite current regimen of mucormycosis remains unacceptable. Focusing on eliminating predisposing factors seems more feasible than the foreboding nephrotoxic effect of antifungal therapy with its added resistance. This article aims to highlight the fact that therapy to control ketoacids and iron chelating agents, along with antifungal, should be used to augment the results.