Mucormycosis and Invasive Aspergillosis in a Parotid Swelling Masquerading as Neoplastic Lesion in an Immunocompetent Host: A Case Report
摘要
Mucormycosis and aspergillosis species are angio-invasive fungi that predominantly affect the sinonasal tract. Primarily, an infection of the immunocompromised disease in immunocompetent individuals has scarcely been reported. The generally high mortality associated with these conditions implies that prompt diagnosis and early intervention are incumbent, particularly in atypical presentations, the recognition of which requires a high degree of clinical suspicion. Here we report an extremely rare case of mucormycosis and aspergillosis of the parotid gland, highlighting management protocols and diagnostic challenges. A 32-year-old male presented with a progressively enlarging, tender swelling in the right parotid region, accompanied by intermittent low-grade fever. Radiological evaluation revealed extensive soft tissue inflammation and ulceration. Initial biopsies suggested invasive aspergillosis, while subsequent specimens revealed mucormycosis. The patient underwent multiple surgical debridements and received systemic antifungal therapy, including liposomal amphotericin B. Despite the aggressive disease course, he had no identifiable immunocompromising condition and responded well to treatment initially. Infection of the parotid gland by mucormycosis and aspergillosis is highly unusual, particularly in immunocompetent subjects. Our case underscores the necessity of alertness in unusual presentations; without the common precipitating risk factors, the significance of early diagnosis, commencement of appropriate antifungal therapy, and early surgical intervention.