Bread mold infection in diabetes. The life-threatening condition of rhinocerebral zygomycosis.

Rhinocerebral zygomycosis is a rare but dangerous fungal infection that affects primarily diabetic patients in ketoacidosis but other debilitated patients as well. A high index of suspicion among primary care physicians will lead to earlier diagnosis and help reduce the severe morbidity and mortality associated with the condition. Zygomycosis should be strongly suspected in diabetic patients presenting with unilateral headache, nasal congestion, or facial pain and swelling. If hyphae are not seen in nasal secretions on microscopy, biopsy of infected tissue must be done immediately to establish a diagnosis. Prompt treatment, including appropriate surgical intervention, amphotericin B therapy, and correction of metabolic derangements, is essential.