An elderly female presented with blockade, nasal discharge, diplopia and facial swelling. On examination, there is blackish discharge from the nasal cavity with necrosis of nasal mucosa, facial skin and palate. There is fixation of the right globe. There is elevated blood sugar and urinary ketones are positive.Which of the following would be the medication to be used in this patient?
Amphotericin B
Itraconazole
Ketoconazole
Broad spectrum antibiotics
Ans. a. Amphotericin B (Rcf : Harrison l9/e p1350,18/ep l661-l664)This diabetic patient is most likely suffering from mucormycosis, in which there is involvement of peri-orbital region and visual impairment. I.V. Amphotericin BQ is the treatment most commonly used in all forms of Mucormycosis.