A 50-year-old diabetic and hypeensive male, presented with diplopia for 1 day along with facial swelling and difficulty in speaking. Patient was in distress. O/E, Febrile Hypeension Tachycardia Right sided proptosis, facial edema and facial palsy Lab findings revealed leukocytosis, increased serum glucose and deranged RFTs. On site cytopathology was taken. All of the following can be used in the management of the above condition except: -
This is a case of invasive rhinocerebral mucormycosis. Cytopathology image shows thick walled, wide ribbon shaped non-septate organisms branching at 90 degrees. Risk factors are hyperglycemia and metabolic acidosis due to CKD. Insulin and hemodialysis- corrects hyperglycemia and metabolic acidosis. DOC is Amphotericin B. Voriconazole is not indicated here.
Insulin
Hemodialysis
Voriconazole
Amphotericin B
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