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Figure 1. A 45-year-old woman with poorly controlled insulin-dependent diabetes mellitus had facial and periorbital swelling for three to four days. On the day of admission she was unable to open her right eye (Panel A). On admission she had a white-cell count of 22,000 per cubic millimeter, with 84 percent neutrophils and bands and a moderate degree of metabolic acidosis (blood pH, 7.22; plasma bicarbonate concentration, 8 mmol per liter). A computed tomographic scan of the head (Panel B) showed involvement of the paranasal sinuses (arrow) and periorbital soft tissues. Material from the periorbital tissue (Panel C), stained . . . [Full Text of this Article] |