A 55-year-old male presented to the hospital with fever and cough since the past one week. The fever was on and off with intermittent headache. He had been diagnosed with diabetes mellitus (DM) five years back for which he had taken oral hypoglycaemic which he discontinued after four months and has been on herbal therapy since.On admission the patient was afebrile (36.4degree), his pulse rate was 100 beats per minute and BP of 120/70 mmHg. Physical examination was normal, on auscultation of chest occasional coarse crepitations were found and rest of the systems was normal. Laboratory investigations revealed haemoglobin of 16.8 g/dL, total white blood cell of 28000 cells per cumm (80% neutrophil) and ESR of 50mm in first hour. Serum biochemistry showed creatinine 2.3mg/dL, blood glucose level was 374 mg/ dL, sodium 131 mmol/L, potassium 4.7 mmol/L. Urine analysis revealed a 1.5% glucose, ketone bodies, and albumin 2+. Chest radiograph showed left upper lobe homogenous opacity suggesting consolidation [Table/ Fig-1]. He was empirically started on ceftriaxone.His sputum was sent for analysis which showed fungal elements on KOH mount. Diagnostic nasal endoscopy showed extensive crests filling left nasal cavity and maxillary sinus which was suggestive of mucormycosis.The patient was started on insulin therapy and amphotericin B intravenously at 1.5mg/kg body weight for 21 days with oral fluconazole of 150mg daily for six weeks. Renal profile was ABSTRACTMucormycosis is the name given to several different diseases caused by fungi of the order mucorales. It is commonly seen in patients with decreased immunity like patients with chronic renal failure, organ transplantation, neutropenia and most commonly in those with poorly controlled diabetes. We present a case of 55-year-old diabetic man who presented with headache and fever diagnosed with pulmonary and maxillary sinus mucormycosis presenting as diabetic ketoacidosis.
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