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Dentistry · Oral medicine and oral cancer: opportunistic fungal infection
Sample itemA 55-year-old with poorly controlled diabetic ketoacidosis has facial pain, nasal discharge and a black necrotic ulcer on the hard palate that does not blanch. Which is the most urgent treatment?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
D. Liposomal amphotericin B with surgical debridement
Rhino-orbito-cerebral mucormycosis produces a black palatal eschar from angioinvasion. Treatment is correction of the metabolic state, amphotericin B and urgent surgical debridement.
Option by option
A. Topical corticosteroid
Steroids would worsen the fungal invasion.
B. Oral fluconazole alone
Fluconazole has no activity against Mucorales.
C. Oral nystatin rinses
Nystatin rinses treat superficial candidiasis only.
D. Liposomal amphotericin B with surgical debridement (correct)
Correct. Amphotericin and debridement are the standard.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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