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A 57-year-old man with leukocytosis and sphenoid sinus disease
Digital Journal of Ophthalmology 2020
Volume 26, Number 2
April 24, 2020
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Ansuya P. Deosaran, MD | Department of Ophthalmology, Louisiana State University, New Orleans, Louisiana
Ahmaida Zeglam, MD | Department of Ophthalmology, University of Florida, Gainesville, Florida
Mary K. Wilson, BS | College of Medicine, University of Florida, Gainesville, Florida
Andres Gonzalez, MD | Department of Ophthalmology, University of Florida, Gainesville, Florida
Matthew J. Gray, MD | Department of Ophthalmology, University of Florida, Gainesville, Florida
Treatment
The patient was initially admitted for intravenous ampicillin/sulbactam, intranasal steroids, and one dose of intravenous dexamethasone.

His IOP spikes on day 2 in the right eye and day 3 in the left eye were treated with brimonidine 0.2%, dorzolamide 2%, and timolol 0.5% each twice daily in the right eye.

Three days after admission, an urgent sinus sphenoidotomy showed no necrotic tissue, purulence, or fungal debris. He was transitioned to vancomycin, cefepime, metronidazole, and amphotericin. On post-admission day 11, he became diaphoretic, obtunded, and hypotensive, with no response to resuscitation. He was transitioned to comfort care and died that day.
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