Abstract
A 41-year old female presented to the emergency department (ED) for evaluation of difficulty with nasal breathing associated with severe internal nasal pain for 3 days. She has a history of chronic opioid abuse via nasal insufflation of crushed oxycodone. Two days before symptom onset, she completed a 10-day course of amoxicillin/clavulanate for a clinically diagnosed maxillary sinusitis. A
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