Facial paralysis and epistaxis in a diabetic: a typical presentation for rhinocerebral mucormycosis

A 60-year-old, poorly controlled diabetic presented to the emergency department with "facial swelling." She was found to have epistaxis and ipsilateral palsies of cranial nerves I through IX. An ischemic area of the left hard palate was also noted, leading to the diagnosis of rhinocerebral mucormycosis. This disease, inevitably lethal if untreated, should be sought in all diabetics with signs or symptoms suggestive of sinus or neurological disease.