Two debilitated, poorly controlled diabetic patients had orbital phycomycosis. Suspicion of phycomycosis resulted in diagnosis within hours after the onset of symptoms in each case. Examination of the nose revealed black crusts on the middle turbinates that contained nonseptate hyphae. Therapy consisted of correction of hyperglycemia and electrolyte imbalances, intravenous amphotericin B, and surgical debridement. Early diagnosis and prompt institution of therapy undoubtedly contributed to survival of both patients. Evidence of unilateral orbital cellulitis with ophthalmoplegia or vascular occlusion should suggest the diagnosis of phycomycosis in diabetics and other debilitated patients, particularly those receiving antibiotics and immuno-suppressives.
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