title: Invasive aspergillosis presenting as swelling of the buccal mucosa in an immunocompetent individual.
abstract: Fungi are ubiquitous in nature but have low virulence and cause disease usually when the host defenses are compromised. Fungal infections of the central nervous system are rare and are usually seen in immunocompromised patients. However, in recent years, there has been an increase in the number of central nervous system fungal infections in immunocompetent individuals. Intracranial fungal granulomas are rare space-occupying lesions. Among these, Aspergillus granuloma is the most common. Craniocerebral involvement by aspergillosis usually occurs via the hematogenous route or through contiguous spread from the paranasal sinuses. Predominant symptoms associated with cranial fungal granuloma include headache, vomiting, proptosis, and visual disturbances. Common signs include papilledema, cranial neuropathy, hemiparesis, and meningismus. We present a case of invasive Aspergillus granuloma in an immunocompetent individual, who presented with a palpable mass in the buccal mucosa following removal of an impacted mandibular third molar but with no other characteristic signs and symptoms of invasive fungal granuloma. To our knowledge, there is no documentation of aspergillosis presenting as a swelling in the buccal mucosa. Unexplained swellings in the buccal mucosa should be viewed with a high degree of suspicion and investigated thoroughly at the earliest.
authors.affiliation: Fellow, Department of Cranio-Maxillofacial Surgery, Mazumdar Shaw Medical Center, Narayana Health City, Bommasandra Industrial Estate, Bangalore, India.
authors.forename: Praveen
authors.initials: P
authors.lastname: Ganesh
authors.affiliation: Fellow, Department of Cranio-Maxillofacial Surgery, Mazumdar Shaw Medical Center, Narayana Health City, Bommasandra Industrial Estate, Bangalore, India. Electronic address: murali_oms@yahoo.co.in.
authors.forename: Muralidhara
authors.initials: M
authors.lastname: Nagarjuna
authors.affiliation: Consultant, Cranio-Maxillofacial Surgery, Mazumdar Shaw Medical Center, Narayana Health City, Bommasandra Industrial Estate, Bangalore, India.
authors.forename: Samarth
authors.initials: S
authors.lastname: Shetty
authors.affiliation: Consultant, Department of Otolaryngology, Mazumdar Shaw Medical Center, Narayana Health City, Bommasandra Industrial Estate, Bangalore, India.
authors.forename: Pradeep
authors.initials: P
authors.lastname: Kumar
authors.affiliation: Consultant and Department Head, Department of Radiodiagnosis, Mazumdar Shaw Medical Center, Narayana Health City, Bommasandra Industrial Estate, Bangalore, India.
authors.forename: Venkatraman
authors.initials: V
authors.lastname: Bhat
authors.affiliation: Medical Director and Chief of Cranio-Maxillofacial Surgery Services, Mazumdar Shaw Medical Center, Narayana Health City, Bommasandra Industrial Estate, Bangalore, India.
authors.forename: Paul C
authors.initials: PC
authors.lastname: Salins
mesh_terms: D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001228:Aspergillosis / Q000188:drug therapy / Q000601:surgery*; D001706:Biopsy; D003131:Combined Modality Therapy; D003287:Contrast Media; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging; D005260:Female; D006099:Granuloma / Q000188:drug therapy / Q000382:microbiology* / Q000601:surgery*; D006801:Humans; D009061:Mouth Mucosa / Q000382:microbiology* / Q000601:surgery*; D065819:Voriconazole / Q000627:therapeutic use
chemical_list: D000935:Antifungal Agents; D003287:Contrast Media; D000666:Amphotericin B; D065819:Voriconazole