A 52-year-old male diabetic presents with a week-long history of fever, headache, confusion, facial nerve palsy with pain and a black, purulent nasal discharge. He is referred to ICU for his deteriorating level of consciousness.
Give the most likely diagnosis. (20% marks)
List four predisposing factors. (10% marks)
List the specific management of this condition. (40% marks)
- Rhinocerebral mucormycosis or fungal sinus infection with cerebral spread.
- HIV/AIDs Diabetes
- Cancer – lymphoma
- Renal failure
- Organ transplantation
- Long term steroid or immunosuppressive therapy
- Deferoxamine therapy
- Iron overload
- Investigation with MRI or CT to determine the extent of the spread.
- Blood culture and biopsy to obtain tissue for fungal culture +/- Surgical debridement if amenable
- Amphotericin B
- Possibly hyperbaric oxygen therapy.
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