Queston #22267Note

This patient with a history of poorly-controlled diabetes, who is now presenting with sinus pressure and mental status changes most likely has rhinocerebral mucormycosis. This is a rare fungal infection with the Mucor or Rhizopus species that affects the nose, paranasal sinuses, and brain. It is an opportunistic pathogen, most commonly seen in immunocompromised patients such as those with poorly-controlled diabetes. The infection starts in the nasal cavity and can extend to the paranasal sinuses and eventually to the brain. Symptoms are nonspecific but often include headache, nasal congestion, rhinorrhea, facial pain and numbness, diplopia, and/or blurry vision. Diagnosis is made by biopsy of antral necrotic tissue which will show fungal hyphae. Mucormycosis spreads rapidly and is highly invasive, so early treatment is necessary. The gold standard of therapy is 4-6 weeks of Amphotericin B