Most commonly associated Fungus with orbital cellulitis in patients with Diabetic Ketoacidosis is
(B) MucorRhino - Orbital mucormycosis:Mucormycosis is a very rare opportunistic infection caused by fungi of the family Mucoraceae, which typically affects patients with diabetic ketoacidosis or immunosuppression. This aggressive and often fatal infection.Specific infections - rhinocerebral mucormycosis:Fungal infection caused by order of mucorales (mucor, rhizopus, absidia).Usually seen in diabetic ketoacidosis.Fungus inhaled into paranasal sinuses, germinates and invades palate, sphenoid, cavernous sinus, orbit, brain.Neurological deficits occur when fungus involves vessels.Proptosis, visual loss ophthalmoplegia, cranial nerve palsies occur. #SIS CLASSIFICATION OF MUCORMYCOSIS & ASPERGILLOSIS AspergillosisMucormycosis (rhino-orbital cerebral mucormycosis)OrderOrder EurotialesOrder MucoralesGenus Aspergillus SpeciesAspergillus fumigatusRhizopus orzae (most common - 90%)Aspergillus flavusAbsidiaAspergillus nigerMucor Rhizomucor pusillus Apophysomyces elegansHyphaeSeptate with dichomatous branches at 45degNon septate filamentous fungi branched at 45degThis is a purulent inflammation of the cellular tissue of the orbit.It is due most frequently to extension of inflammation from the neighbouring parts, especially the nasal sinuses; other less common causes are deep injuries, especially those with a retained foreign body, septic operations, posterior extension of suppurative infections of the eyelids or the eyeball such as panophthalmitis, facial erysipelas, or metastases in pyaemia.In diabetics a particularly fulminant infection with Mucor or Aspergillus is possible.Biopsy to find out non-septate broad branching hiphae.Treatment:Correction of underlying metabolic defect.Intra venous antifungal, antibiotics, E.g., Amphotericin-BWide excision of devitalized necrotic tissues exenteration may be required.Hyperbaric oxygen.Phacomycosis:Mucormycosis is rare a aggressive & often fatal infection caused by the fungus of family Mucoraceae, infection acquired by inhalational of spores.Other Options[?]Candida Ophthalmic Infections:The eye infections that may be caused by Candida species range from extraocular (keratitis, orbital cellulitis) to intraocular (endophthalmitis, panophthalmitis).[?]Aspergillus:Aspergillosis is caused by fungus in the order Eurotiales and genus Aspergillus.[?]Histoplasma:Presumed ocular histoplasmosis syndrome (POHS) occurs secondary to infection with the yeast form of Histoplasma capsulatum. The disease is characterized by atrophic chorioretinal scars, peripapillary atrophy (PPA) & the absence of vitritis.
Candida
Mucor
Aspergillus
Histoplasma
Systemic Disease