Invasive Sinusitis Due to Phaeohyphomycosis Presenting as Teeth Luxation and Necrosis of the Hard Palate: A Rare Post-COVID-19 Case Scenario

Abstract

Introduction

Phaeohyphomycosis usually presents as superficial or subcutaneous infections. However, in immunocompromised patients with disseminated disease, there is a high probability of cerebral invasion; hence, it must be detected before the fungi reach this stage.

Case Report

Here, we report a case of phaeohyphomycosis that presented with subluxation of teeth, 2 years post-COVID, and was found to have blackish discoloration of the alveolar bone with features of necrosis. Histopathological examination of biopsy samples was positive for phaeohyphomycosis, with positive Periodic acid-Schiff (PAS) and Fontana–Masson staining. Following diagnosis, surgical debridement of the polypoidal tissue and necrotic bone was done along with left uncinectomy. The patient was started on IV amphotericin B and oral voriconazole. The patient had complete resolution of symptoms 3 months after initiation of treatment.

Conclusion

Phaeohyphomycosis has been reported to have high mortality and morbidity. Hence, timely diagnosis and initiating appropriate antifungal therapy as soon as possible are important to reduce the fatal consequences of phaeohyphomycosis infection.