Until recently most cases of oral aspergillosis were thought to represent spread from the nose or sinuses (Schubert 1986, Chambers 1995) . Infection starting at the gingival margin ( manifest as painful necrosis) and spreading rapidly to the contiguous mucosa, muscle and bone in neutropenic patients has now been described (Sugata, 1994). In addition aspergillosis of the tongue has been described in AIDS at autopsy (Leonard 1997).
Control of disease is possible with systemic antifungal therapy, local debridement of affected tissues and recovery of neutropenia. In cases where there is spread from the sinuses or nose surgical therapy is necessary for diagnosis. The impact of major surgical resection is probably small (Denning 1990, Kennedy 1997) and should be reserved for cases with no other therapeutic avenue.