A 68-YEAR-OLD African American man was referred for evaluation of left-sided nasal obstruction of 1 month's duration. He also noted some mild swelling of the left side of his face. He denied headaches, facial pressure, rhinorrhea, sneezing, epistaxis, decreased sense of smell, or problems with his teeth. Also, he had no history of fever, chills, night sweats, weight loss, or previous nasal problems. He was treated with beclomethasone spray, without relief of symptoms.
His medical history was significant for hypertension, insulin-dependent diabetes, and end-stage renal disease, necessitating hemodialysis. His medications included a prescription multivitamin supplement (Nephrocaps; Fleming & Co, Fenton, Mo), clonidine, nifedipine (Procardia), docusate sodium, calcium carbonate, insulin, and allopurinol. He did not smoke tobacco or drink alcohol.