Mucor and Aspergillus Maxillary Bone and Sinuses coinfection in a woman with Systemic Lupus Erythematosus: A Case Report

Background: Mucorales and Aspergillus have invasive fungal infections with high mortality, mainly in immunocompromised and diabetic patients. The diagnosis is microbiological and pathological, with a strong clinical suspicion. The treatment is medical and surgical debridement. Invasive fungal coinfection by these two is reported as a case report. Here, we highlight the importance of considering the coinfection of Aspergillus and Mucor in the maxillary bone and paranasal sinuses in patients with systemic lupus erythematosus (SLE). Cases Report: A 38-year-old woman had a fever and toothache 1.5 months before and had been treated for a dental abscess, which continued to fever, epistaxis, teeth out spontaneously, left Bell’s Palsy, and swelling in the left side of her face. She had a history of immunosuppressive therapy and steroid-induced hyperglycemia for SLE. The PNS CT Scan found increased mucosal thickness of the left maxilla and sphenoid sinuses. Extensive debridement was done. Pathologic study of debrided samples showed coinfection of invasive mucormycosis and aspergillosis. She was treated with liposomal amphotericin B and voriconazole with complete recovery without recurrence after a one-year follow-up. Conclusion: In mucor and aspergillus coinfection, no one should be missed at first and treated by specific antifungal amphotericin B, with no time-wasting for a better prognosis.