Things not to miss - Mucormycosis



A 54 years old male patient with a history of diabetes mellitus for 12 years came to see his family doctor with a complain of fever and phlegm. Headache was mainly over the right side. He had rhinitis with yellowish discharge and nasal block. He was poorly compliant with the treatment for diabetes and his FBS usually fluctuated around 200mg/dl. Doctor started him on oral coamoxyclav, paracetamol and fexofenadine as for sinusitis.

Three days later he presented again complaining of persistent phlegm. He also complained of some numbness and fullness over the right side of the face. There was tenderness over the maxillary sinus. A Xray of the sinus view was ordered.



The doctor was convinced that the diagnosis was sinusitis in view of the haziness in the right maxillary sinus. However, as the response was poor he asked the patient to get admitted to hospital to be seen by an ENT surgeon. Patient refused admission saying that his daughter was about to leave the country for her studies in a few days time. Therefore, the doctor decided to send the patient home with oral Moxifloxacin.

Three days later patient was brought to the hospital in a confused state. He was blind in his right eye.

(Picture from internet)



What is the probable diagnosis that was missed?
What would be the most likely outcome of the patient now?

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