Received by the Editorial Office: May 18, 2026
Accepted for publication: June 9, 2026
Published online: June 30, 2026
UDC: 616.716-002.828:616.98:578.834.1
DOI: 10.70113/1815-9443.2026.92.55.013
POST-COVID-19 MAXILLOFACIAL MUCORMYCOSIS: A REPORT OF THREE CASES
Y.Menchisheva1, S. Mussabekova2, M. Khairoyev3, I. Akzhigit3, K. Zubanov1
1Department of oral and maxillofacial surgery, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
2Department of Morphology, School of Medicine, Karaganda Medical University, Karaganda, Kazakhstan
3Department of oral and maxillofacial surgery, Hospital 5, Almaty, Kazakhstan
Introduction. Mucormycosis is a rare but highly aggressive angioinvasive fungal infection that has become increasingly associated with coronavirus disease 2019 (COVID-19), particularly in immunocompromised patients. Although rhino-orbito-cerebral involvement is the most common presentation, maxillofacial manifestations remain uncommon and insufficiently described.
Objective. To describe the clinical presentation, diagnostic approach, management, and outcomes of three cases of post-COVID-19 maxillofacial mucormycosis with atypical anatomical involvement.
Materials and methods. Three female patients diagnosed with post-COVID-19 maxillofacial mucormycosis between 2023 and 2025 at the Department of Maxillofacial Surgery, Hospital No. 5, Almaty, Kazakhstan, were retrospectively analyzed. Clinical examination, cone-beam computed tomography (CBCT), magnetic resonance imaging (MRI), direct microscopy, fungal culture, and histopathological assessment were used for diagnosis. All patients received systemic antifungal therapy combined with surgical debridement.
Results. The mean age of the patients was 52.7±9.2 years. One patient presented with mandibular involvement, another with maxillary and palatal osteonecrosis, and the third with isolated oropharyngeal soft tissue involvement. All patients had a documented history of recent COVID-19 infection, while two patients also had diabetes mellitus and prior corticosteroid therapy. Direct microscopy revealed broad non-septate hyphae characteristic of mucormycosis, and fungal cultures identified Rhizopus species. Management included liposomal amphotericin B followed by posaconazole and surgical debridement of necrotic tissues. Two patients demonstrated complete clinical recovery without recurrence during 12-month follow-up, whereas one patient with isolated oropharyngeal involvement died due to systemic complications despite aggressive treatment.
Discussion. The presented cases highlight the important role of COVID-19-associated immune dysregulation, diabetes mellitus, and corticosteroid therapy in the development of mucormycosis. In addition, recent dental extractions may serve as a portal of fungal inoculation, particularly in immunocompromised individuals. The variability of anatomical involvement emphasizes the diagnostic challenge of atypical maxillofacial mucormycosis and the need for early multidisciplinary management.
Conclusion. Post-COVID-19 maxillofacial mucormycosis may present with uncommon involvement of the mandible, maxilla, palate, and oropharyngeal soft tissues. These cases highlight the importance of early diagnosis, mycological confirmation, and multidisciplinary management in high-risk patients.
Keywords: Mucormycosis, maxillofacial fungal infection, post-COVID, fungal disease, antifungal therapy
