Zygomycosis is an opportunistic fungal infection caused by inhaling spores of the zygomycetes fungi. It most commonly affects the sinuses and palate. Clinical findings include nasal obstruction, bloody discharge, facial pain or swelling. Left untreated, it can cause extensive tissue destruction and necrosis of the palate, sinuses and potentially the cranial vault. Diagnosis is made through biopsy and identification of broad, non-septate fungal hyphae on histopathology. Treatment involves aggressive surgical debridement and antifungal therapy with amphotericin B, along with controlling any underlying diseases such as diabetes that increase risk.

1. MUCORMYOCIS

2. ZYGOMYCOSIS
• Opportunistic, fulminant fungal infection
• Caused by zygomycetes
• Spores liberated in air and inhaled
• Rhinocerebral form most relevant
• Noted in insulin dependent diabetes and immunocompromised patients

3. PATHOGENESIS

4. CLINICAL FINDINGS
• Nasal obstruction
• Bloody nasal discharge
• Facial pain or headache
• Facial swelling, cellulitis
• Visual disturbance
Diffuse tissue destruction involving nasal and maxillary structures

5. • With cranial vault involvement
blindness, lethargy and seizures
followed by death
• If maxillary sinus is involved intraoral
swelling of palate
• If untreated palatal ulceration
• Surface of ulcer appear black and
necrotic
• Massive tissue destruction
Extensive black, necrotic lesion of palate represents zygomycotic infection extended from maxillary
Sinus in a patient with poorly controlled type I diabetes mellitus

6. RADIOGRAPH
• Opacification of sinuses in conjunction with patchy effacement of bony walls of
sinuses

7. HISTOPATHOLOGIC FEATURES
• Extensive necrosis with numerous large 6-30micrometer, branching, nonseptate
hyphae at periphery
• 90 degree branching
• Tissue destruction is due to fungal invasion into small blood vessels
• Disrupts blood flow and results in infarction and necrosis
• Neutrophilic infiltrate predominates

8. Large nonseptate fungal hyphae characteristic of zygomycotic organisms

9. DIAGNOSIS
• Based on Histopathology

10. TREATMENT AND PROGNOSIS
• Radical surgical debridement of infected, necrotic tissue and systemic
administration of amphotericin B
• Underlying disease to be controlled
• Prosthetic obturation to defects