Question

A diabetic patient presented with rhinitis and facial swelling. An intranasal biopsy revealed the presence of broad-based aseptate hyphae with branching at right angle. Evidence of vascular invasion was present. What will be the drug of choice for this condition?

• A. Fluconazole
• B. Amphotericin B
• C. Ketoconazole
• D. Griseofulvin

Answer 1

The Correct Option is B

The clinical scenario presents a diabetic patient with rhinitis and facial swelling, where an intranasal biopsy indicates broad-based aseptate hyphae with right-angle branching and vascular invasion. This description is characteristic of a mucormycosis infection, primarily caused by fungi in the order Mucorales. Mucormycosis is an aggressive and potentially life-threatening infection, especially common in immunocompromised individuals such as diabetic patients.

Identifying the correct drug to treat this condition is crucial. Let's analyze the provided options:

• Fluconazole: This is a commonly used antifungal for Candida and some Cryptococcus infections, but it is ineffective against mucormycosis.
• Ketoconazole: Another antifungal that is effective against different dermatophyte and yeast infections, but not typically used for mucormycosis, due to poor efficacy and side effect profile.
• Griseofulvin: Used mainly for dermatophyte infections affecting skin, hair, and nails. It is not suitable for systemic fungal infections like mucormycosis.
• Amphotericin B: This is the drug of choice for treating mucormycosis due to its potent antifungal activity against the Mucorales fungi. Amphotericin B works by binding to the fungal cell membrane, causing increased permeability and cell death. Despite potentially severe side effects, its efficacy in treating life-threatening fungal infections makes it the preferred treatment.

Considering the above analysis, the most effective treatment for this condition, given the nature of the fungal infection, is Amphotericin B.