A 40-year old diabetic patient presents with proptosis of one eye and black eschar over palate. The likely organism is:
Correct Answer: Mucor
Description: Mucormycosis can affect the upper respiratory, pulmonary, cutaneous, gastrointestinal, and central nervous systems. The clinical manifestation of the condition is headache with nasal discharge and sinus pain. Infection quickly spreads from the sinuses to contiguous structures. Ocular involvement manifests as proptosis, periorbital edema, ophthalmoplegia, or vision loss. Angioinvasion by hyphae leads to a black necrotic eschar on the palate or nasal mucosa. Infection spreading from the ethmoid sinus to the frontal lobe can cause obtundation. Mucormycosis in immunocompromised patients typically occurs with spore inhalation or through skin lacerations. Hyperglycemia, usually with related metabolic acidosis, is the most common underlying condition associated with mucormycosis. Rhinocerebral mucormycosis is rapidly fatal and should be suspected in high-risk patients presenting with sinusitis, paicularly those with diabetes and metabolic acidosis. Altered mental status that persists after metabolic abnormalities are corrected suggests possible central nervous system (CNS) infection. Diagnosis is based on histopathology with culture confirmation Treatment requires prompt and aggressive surgical debridement and antifungal therapy with amphotericin B ref - pubmed.com
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