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Rhinocerebral Mucormycosis — RACP Adult Medicine MCQ

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ModerateInfectious DiseasesRhinocerebral MucormycosisRACP Adult Medicine

A 60-year-old man with poorly controlled diabetes presents with facial pain, proptosis, black nasal eschar, and ophthalmoplegia. CT shows destruction of the ethmoid and maxillary sinuses with extension into the orbit and cavernous sinus. He is severely unwell with DKA. Tissue biopsy shows broad, ribbon-like, non-septate hyphae branching at right angles. What is the most likely diagnosis?

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Correct answer: B — Mucormycosis

Rhinocerebral mucormycosis presents with facial pain, black eschar (tissue necrosis from angioinvasion), proptosis, ophthalmoplegia, and sinus destruction. Risk factors: DKA, neutropenia, iron overload (deferoxamine). Biopsy showing broad non-septate hyphae (vs narrow septate hyphae in Aspergillus) is diagnostic. Treatment: urgent surgical debridement + IV liposomal amphotericin B. Correction of DKA is essential.

Reference: eTG Antibiotic – 2025 – Mucormycosis; ECMM/ISHAM 2024