This patient presents to the ED with delirium resulting from diabetic ketoacidosis. She also has a variety of ENT complaints, including recent bloody nasal discharge and confusion. Read the details of this case and see if you can make the diagnosis.
A 67-year-old woman with type 2 diabetes mellitus presented to the emergency department with delirium resulting from diabetic ketoacidosis. She also complained of headache, facial pain, nasal congestion, left eye pain, and blurry vision of 2 weeks’ duration. She noted recent bloody nasal discharge and confusion. The CT scan shown here of the patient’s sinus showed ethmoidal sinus congestion with air-fluid levels in the sphenoidal sinuses. Maxillary sinuses and turbinates appeared thickened, and there was left supraorbital soft tissue swelling. Histopathology using Gomori methenamine-silver nitrate stain is shown here.
What is your impression?