A woman in her 70s was presented with acute right eye vision loss. She had a history of pulmonary embolism, diplopia and blurry vision (2-week), nasal congestion and progressive headaches for months without any relief from multiple antibiotic courses.
The patient denied a medical history of autoimmune disease, diabetes, immunodeficiency, malignant disease, or sinonasal issues. Investigations The patient was afebrile with stable vitals Hematology profile: Normal WBC count, increased ESR and C-reactive protein Ophthalmologic evaluation: Right afferent pupillary defect and cranial sixth-nerve palsy CT and MRI of sinus: Abnormal soft tissue throughout sinuses with the destruction of the sinus walls, skull base and extension of abnormal tissue into the right orbital apex and posterior nasal septum Nasal endoscopy: Showed bloody mucus around the right middle turbinate and sphenoethmoidal…
