Young Man With Fever and Eye Pain

Abstract

A 21-year-old man presented with several days of fever, sinus pain, decreased vision, and pain with eye movement. Examination revealed proptosis and periorbital edema/erythema, with an afferent pupillary defect and a visual acuity of hand-motion in the right eye (Figure 1). A computed tomography (CT) scan showed opacification of the frontal, ethmoid, and maxillary sinuses bilaterally, with right-sided orbital inflammatory changes and a subperiosteal abscess in the superomedial orbit (Figure 2). The patient began receiving vancomycin, ceftazidime, and metronidazole.