A neutropenic patient has facial numbness, a pale insensate middle turbinate and rapidly progressive ophthalmoplegia. Frozen section confirms broad non-septate hyphae. What is the best immediate strategy?
Mucormycosis is angioinvasive; survival depends on rapid combined source control, antifungal therapy and correction of host factors.
A. Wait for final culture before treatment: Culture sensitivity is limited and delay is dangerous after histological confirmation.
B. Topical antifungal drops alone: They cannot treat angioinvasive skull-base and orbital disease.
C. Orbital exenteration in every patient: Radical orbital surgery is selected by disease extent and response, not automatic.
D. Steroids for presumed orbital inflammation: Immunosuppression can accelerate fungal invasion.
E. Urgent repeated surgical debridement plus systemic antifungal treatment and reversal of immunosuppression where possible: Mucormycosis is angioinvasive; survival depends on rapid combined source control, antifungal therapy and correction of host factors.
If septate acute-angle branching hyphae suggested Aspergillus, antifungal selection would change while urgent debridement remained essential.
Independent Clinora preparation material; not official JCIE content, an accredited programme or a substitute for local policy and specialist judgement.
Back to the Section 1 bank