COVID-RELATED MUCORMYCOSIS ("BLACK FUNGUS") MIMICKING DENTAL INFECTION: REPORT OF THREE CASES

A recent increase in the prevalence of mucormycosis of the head and neck in patients who have recovered from COVID-19 hospitalization has been reported. We report three cases of post-COVID-19 associated rhinocerebral mucormycosis presenting unexplained dental signs and symptoms mimicking tooth mobility, periodontal disease, and dental abscesses. The three cases involve men with history of hospitalization for COVID-19 infection and treated with high doses of corticosteroids. Two showed tooth mobility and bone destruction in computed tomography. A biopsy was performed in all cases. The first presented microscopic examination with non-viable bone and peripheral resorption. Periodic acid-Schiff staining of the fungus highlighted these organisms associated with areas of tissue destruction and necrosis. The second revealed non-viable bone fragments surrounded by spores and non-septate fungal organisms. The third revealed non-viable and necrotic bone fragments surrounded by bacterial colonies with numerous non-septate fungal hyphae. All cases were diagnosed as rhinocerebral mucormycosis infection.