Figure 1.

(A) 58 year-old female in diabetic ketoacidosis presents with decreased vision, chemosis, proptosis and ophthalmoplegia on the left side concerning for AFIFS. (B) Oral exam demonstrates poor dental hygiene and necrosis of the hard palate. (C) Endoscopic exam reveals necrosis of the left inferior turbinate which was removed during debridement. Tissue culture eventually grew Rhizopus microsporious. (D) Orbital exenteration was performed in conjunction with nasal and sinus debridement because of significant orbital involvement seen on imaging. Involvement of the ethmoid sinus air cells can be appreciated through the thin medial wall of the orbit.