Post-COVID-19 Maxillary Bony Sequestration: A Case Report on Mucormycosis Challenges

Abstract

COVID-19-associated mucormycosis (CAM) is a severe opportunistic infection, typically affecting immunocompromised patients. Maxillary bony sequestration as a delayed complication in immunocompetent individuals is rare, highlighting diagnostic and therapeutic challenges. A 31-year-old male with no comorbidities presented in September 2021 with COVID-19 pneumonia (Delta variant), treated with dexamethasone and remdesivir. In October 2021, he developed right maxillary hypoesthesia and cheek swelling. Nasal endoscopy and biopsy confirmed mucormycosis, managed with liposomal amphotericin B and endoscopic debridement. In February 2023, malodor and tooth loosening prompted imaging, revealing maxillary bony sequestration due to fungal-induced vascular thrombosis and necrosis, treated with surgical resection and prosthetic reconstruction. One-month follow-up (March 2023) showed no recurrence or complications, though the short follow-up limits long-term conclusions. This case underscores maxillary bony sequestration as a rare, delayed complication of CAM, even in immunocompetent patients. Persistent symptoms like malodor or tooth mobility warrant imaging and surgical evaluation. Long-term follow-up is crucial to detect and manage such sequelae.