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April 1985

Resident's Page

Author Affiliations

University of Virginia School of Medicine, Charlottesville

Arch Otolaryngol. 1985;111(4):276-279. doi:10.1001/archotol.1985.00800060100018


Anna N. Walker, MD; John G. Etheridge, MD; Warren L. Griffin, MD; Macon, Ga  A 55-year-old man had a one-day history of left-sided blindness and headache. His medical history was remarkable for hypertension and diabetes mellitus, both of several years' duration and both inadequately controlled because of his poor compliance with prescribed regimens. Admission physical examination disclosed left oculoplegia and proptosis with injection of the left cornea. The left pupil was dilated and nonreactive. The right eye appeared normal. The nares and oral cavity were clear. Decreased sensation was noted over the left side of the face. Laboratory data were consistent with the diagnosis of diabetic ketoacidosis. A computed tomographic scan of the patient's head revealed no discrete masses; mucosal thickening of the left maxillary and both ethmoid sinuses, however, was present.Intravenous (IV) insulin therapy was started. The patient's condition, however, deteriorated rapidly; he became