Osteomyelitis of Jaw Bone due to Aspergillosis in Post-COVID-19 Patients: An Observational Study

Abhay Datarkar; Vandana Gadve; Akshay Dhoble; Devendra Palve; Surendra Daware; Hema Anukula; Damyanti Walkey

doi:10.1007/s12663-023-02041-z

Osteomyelitis of Jaw Bone due to Aspergillosis in Post-COVID-19 Patients: An Observational Study

J Maxillofac Oral Surg. 2024 Apr;23(2):308-315. doi: 10.1007/s12663-023-02041-z. Epub 2023 Nov 16.

Authors

Abhay Datarkar¹, Vandana Gadve¹, Akshay Dhoble², Devendra Palve², Surendra Daware¹, Hema Anukula², Damyanti Walkey¹

Affiliations

¹ Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Nagpur, MS India.
² Department of Maxillofacial Pathology and Microbiology, Government Dental College and Hospital, Nagpur, MS India.

PMID: 38601236
PMCID: PMC11001796 (available on 2025-04-01)
DOI: 10.1007/s12663-023-02041-z

Abstract

Background: In the second wave of COVID-19 pandemic, there has been an increase in number of cases with Post-COVID-19 fungal osteomyelitis of jaws. Aspergillosis was found to be one of the causes of osteomyelitis of jaw bones in these patients.

Aim: To evaluate the incidence and pattern of osteomyelitis of jaw due to aspergillosis in post-COVID-19 patients and to discuss the management protocol of the same.

Method: Data were obtained at our institution from the period of January 2021 to June 2021. Patients of all age groups with Post-COVID-19 osteomyelitis of jaw due to aspergillosis and those with combined aspergillosis and mucormycosis infection were included. Patients having rhino-orbito-cerebral fungal infection were excluded.

Results: A total of 47 patients reported to our center. Demographically the average age of the patients was 49.11 years with 72% being males. All 47 patients (N = 100%) had received steroids. 21 of them (N = 44.7%) had diabetes mellitus and 14 (N = 29.8%) patients had other comorbidities. Out of 47 patients, 42 (N = 89.7%) patients were diagnosed with aspergillosis and the remaining 5 (N = 10.3%) cases had a mixed fungal infection of mucormycosis and aspergillosis. On fungal culture Aspergillus flavus was the most common species detected followed by Aspergillus niger and Aspergillus fumigatus. All patients were treated with oral Voriconazole and local surgical debridement. Prompt laboratory testing such as a timely KOH mount, galactomannan test, beta-D-glucan test, histopathology of tissue specimens could help to give an early and definitive diagnosis. The mortality rate we encountered in this study was nil.

Conclusions: Early and definitive diagnosis and immediate initiation of antifungal drug therapy and surgical intervention will significantly reduce the rate of morbidity and mortality.

Keywords: Aspergillosis; Osteomyelitis of jaw; Post-COVID-19 infection; Surgical intervention; Voriconazole.

© The Association of Oral and Maxillofacial Surgeons of India 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.