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PATHOLOGIC QUIZ CASE
James Gamble, MD, Miami, Fla
A 52-year-old obese, diabetic, white woman developed progressive symptoms of a thick purulent nasal discharge, chills and fever, sagging of the right side of her face, and swelling of the right periorbital region four days prior to hospitalization.At the time of admission her temperature was 101 F (38.3 C) and her blood pressure was 220/120. There was marked chemosis and edema of the right periorbital area. Ptosis and a complete ophthalmoplegia were present, the right cornea was cloudy, and reflex was absent; the left eye was normal. A right facial nerve paralysis was also present. The right nasal passage was full of pus and the mucosa was edematous. Her mouth was dry and the right parotid gland area was swollen. In essence, cranial nerves 2 to 7 were nonfunctioning on the right side. The findings of the remainder of the neurological