A 43-year-old type 1 diabetic woman who is poorly compliant with her diabetes medications presented to the emergency department with hemorrhage from her nose. She says that he has lost a significant amount of weight recently despite no significant change in dietary habits. Laboratory studies show a serum pH of 7.1 and positive serum ketones. His mucus membranes are extremely dry. Treatment is initiated, and the patient's condition improves. However, he now has fever, headache, and eye pain. Examination of the nasal cavity shows a black necrotic eschar adherent to the inferior turbinate. Which of the following procedures would most likely reveal the pathogen responsible for this patient's infection?

Question

A 43-year-old type 1 diabetic woman who is poorly compliant with her diabetes medications presented to the emergency department with hemorrhage from her nose. She says that he has lost a significant amount of weight recently despite no significant change in dietary habits.  Laboratory studies show a serum pH of 7.1 and positive serum ketones.  His mucus membranes are extremely dry.  Treatment is initiated, and the patient's condition improves.  However, he now has fever, headache, and eye pain.  Examination of the nasal cavity shows a black necrotic eschar adherent to the inferior turbinate.  Which of the following procedures would most likely reveal the pathogen responsible for this patient's infection?

Quizplus · Accepted Answer

Eductional Objective: Facial pain, headache, and a black necrotic eschar in the nasal cavity of a patient with diabetic ketoacidosis are highly suggestive of mucormycosis.  Histologic examination of the affected tissue is necessary to confirm the diagnosis.  The fungi show broad nonseptate hyphae with right-angle branching.  Treatment consists of surgical debridement and antifungal therapy.

A 43-Year-Old Type 1 Diabetic Woman Who Is Poorly Compliant