Last reviewed: 21 Oct 2024
Last updated: 30 Jul 2021
Summary
Definition
History and exam
Key diagnostic factors
- presence of risk factors
- sinus and facial pain
- eye pain, blurred vision
- proptosis
- cranial nerve palsies
- dry cough, with or without dyspnoea
- skin nodules
Full details
Other diagnostic factors
- fever
- peri-orbital cellulitis
- viscid, dark brown-black nasal discharge
- focal sensory/motor neurological deficits and altered mental status
- necrotic eschar
- haemoptysis
- abdominal pain and distension
- gastrointestinal bleeding
- peritonitis
Full details
Risk factors
- diabetes ± diabetic ketoacidosis
- neutropenia
- iron overload
- corticosteroids
- haematopoietic and solid organ transplantation, graft-versus-host disease
- breakdown of skin and soft tissue
- malnutrition
- prematurity
- liver cirrhosis
Full details
Diagnostic investigations
1st investigations to order
- FBC
- basic metabolic profile
- ABG
- urinalysis
- serum ketone level
- CT sinuses and brain
- CT chest with contrast
- nasal endoscopy
- gastrointestinal endoscopy
Full details
Investigations to consider
- MRI sinuses and brain
- bronchoscopy with bronchoalveolar lavage and trans-bronchial biopsy
- histopathology of biopsy
- microbiology of biopsy
Full details
Emerging tests
- polymerase chain reaction
Treatment algorithm
ACUTE
suitable for surgery
unsuitable for surgery
Contributors
Authors
Rachana M. Palnitkar, MD
Infectious Diseases
Private Practice
Los Gatos
CA
Disclosures
RMP declares that she has no competing interests.
Michael Sands, MD, MPH & TM, FIDSA
Professor of Medicine
College of Medicine
University of Florida
Jacksonville
FL
Disclosures
MS declares that he has no competing interests.
Peer reviewers
Michail Lionakis, MD, ScD
Infectious Diseases Fellow
Laboratory of Molecular Immunology
National Institute of Allergy and Infectious Diseases
NIH
Bethesda
MD
Disclosures
ML declares that he has no competing interests.
Rachael Morris-Jones, PhD, FRCP, PCME
Dermatology Consultant and Honorary Senior Lecturer
Kings College Hospital
London
UK
Disclosures
RMJ declares that she has no competing interests.
Differentials
- Aspergillosis
- Bacterial sinusitis
- Bacterial peri-orbital cellulitis
More DifferentialsGuidelines
- Global guideline for the diagnosis and management of mucormycosis
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