Rhinocerebral zygomycoses

Question 1

Patient presentation

Answer 1

periorbital ecchymoses, orbital cellulitis, cranial nerve palsy, exudate/necrotic tissue in eyes and turbinate bones, fixed pupils, paranasal swellings, coma and death within few weeks

Question 2

Seen in what kind of patients

Answer 2

pts with Diabetic ketacidosis , blood cancers, or profound neutropenic(!!)

Question 3

Lab Dx- microscopy

Answer 3

ribbon like non-septate hyphae with 90 degree angle (broad) branching and NO Conidia (spores) seen in tissues

Question 4

Lab Dx Staining

Answer 4

Gomori Methanamine silver staining (NOT Grocot methanamine silver stain as seen in PCJ)

5-10% KOH with calcofluor white stain

H&E

Question 5

Lab Dx Culture

Answer 5

Mucor in culture ; branching with no rhizoids

Question 6

Absidia

Answer 6

pear shaped columella, rhizoids present in between spores

Question 7

Rhizopus

Answer 7

distinct rhizoids below the sporangiophores, ovoid columella

Question 8

Where does organism have fondness for invading?

Answer 8

blood vessels (angioinvasive) and Brain tissue