A diabetic patient present with bloody nasal discharge, orbital swelling and pain. Culture of periorbital pus showed branching septate hyphae. Which of the following is the most probable organism involved?
High-Yield Explanation
Mucor and Aspergillus species are the most common oppounistic agents causing orbital fungal infections. Immunocompromised and diabetic patients are especially prone to these fungal infections. They usually involve the orbit by direct extension from nasal cavity and paranasal sinuses through bone destruction. Demonstration of branching septate hyphae suggests a diagnosis of Aspergillosis. Hyphae from Zygomycetes (Mucor/Rhizopus) are generally aseptate (septa uncommon). Presence of branching septate hyphae in culture suggests the diagnosis of Aspergillosis. Ref: Manual Of Environmental Analysis By N.C. Aery, Page 153; Color Atlas and Text of Pulmonary Pathology, Page 448; Imaging of the Head and Neck By Mahmood F. Mafee, Page 67; Harrison's Principles of Internal Medicine, 17th Edition, Page 1257, 1259.