Intracranial Complications of Sinusitis

A 5-year-old girl being treated with antibiotics for a recent history of presumptive acute rhinosinusitis presented with recurrence of fever, lethargy, and subacute onset of left lower extremity weakness. On physical examination, she was noted to have neck stiffness and flaccid weakness of the left lower limb, but preserved deep tendon reflexes. Neurologic examination was otherwise unremarkable, including funduscopic examination. Peripheral white blood cell count was markedly elevated at 27 000, with a predominance of neutrophils, and the C-reactive protein value was elevated at 127.

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