Last reviewed: June 2020
Last updated: June  2020

Summary

Definition

History and exam

Key diagnostic factors

  • sinus and facial pain
  • eye pain, blurred vision
  • proptosis
  • cranial nerve palsies
  • dry cough, with or without dyspnea
  • skin nodules

Other diagnostic factors

  • fever
  • periorbital cellulitis
  • viscid, dark brown-black nasal discharge
  • focal sensory/motor neurologic deficits and altered mental status
  • necrotic eschar
  • hemoptysis
  • abdominal pain and distension
  • gastrointestinal bleeding
  • peritonitis

Risk factors

  • diabetes ± diabetic ketoacidosis
  • neutropenia
  • iron overload
  • corticosteroids
  • hematopoietic and solid organ transplantation, graft-versus-host disease
  • breakdown of skin and soft tissue
  • malnutrition
  • prematurity
  • liver cirrhosis

Diagnostic investigations

1st investigations to order

  • CBC
  • basic metabolic profile
  • ABG
  • urinalysis
  • serum ketone level
  • CT sinuses and brain
  • CT chest with contrast
  • nasal endoscopy
  • gastrointestinal endoscopy
More 1st investigations to order

Investigations to consider

  • MRI sinuses and brain
  • bronchoscopy with bronchoalveolar lavage and transbronchial biopsy
  • histopathology of biopsy
  • microbiology of biopsy
More investigations to consider

Emerging tests

  • polymerase chain reaction
More emerging tests

Treatment algorithm

Contributors

Rachana M. Palnitkar

Infectious Diseases

Private Practice

Los Gatos

CA

Disclosures

RMP declares that she has no competing interests.

Michael Sands

Professor of Medicine

College of Medicine

University of Florida

Jacksonville

FL

Disclosures

MS declares that he has no competing interests.

Peer reviewersVIEW ALL

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.

Dermatology Consultant and Honorary Senior Lecturer

Kings College Hospital

London

UK

Disclosures

RMJ declares that she has no competing interests.

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