Mucormycosis

Mucormycosis is a devastating infection in diabetics that has high mortality and requires prolonged treatment with amphotericin B and surgery. The majority of mucormycosis in diabetics is sinus-related disease that may spread to contiguous structures including the face, orbit, and cerebrum. Early diagnosis of mucormycosis is challenging because patients often present with subtle findings. Clinicians should have a high degree of suspicion in patients who present with diabetic ketoacidosis or poorly controlled diabetes and have findings suggestive of disease that involves the sinus, eyes, face, cranial nerves, or altered mental status. Diagnosis is made from tissue scrapings of lesions, tissue biopsy, endoscopic examination, fungal culture, and characteristic tissue histology. Urgent intervention with antibiotics and surgery improves clinical outcomes, but despite appropriate therapy, a significant number of patients will die or be disfigured.