Altered sensorium and multiple cranial nerve palsies in a recently diagnosed diabetic

We report a recent diabetic who presented with hyperglycemic, hyperosmolar, non ketotic state with coma and multiple cranial nerve palsies due to an associated previously undetected sinus infection. This is a classic case revisited purely for its educational value in terms of clinical photographs, tissue biopsy and imaging findings. These findings reiterate the devastating neurological consequences of fungal sinusitis in diabetic patients.