William A. Kantrales, Martin P. Wegman, Jennifer Chapman, Nawzad Jacksi
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Abstract
Background
Acute rhinosinusitis is frequently diagnosed in emergency departments and primary care settings across the United States. Most cases are allergic or viral in etiology and resolve with supportive measures. Complications are rare, but when occurring are typically a result of bacterial sinusitis, extension of infection, and cerebral venous thrombosis. We describe a case of acute rhinosinusitis with co-existing acute angle closure glaucoma.
Case report
A 42-year-old female with history of headache disorder presented to the emergency department with the chief complaint of a left-sided headache, blurry vision, aural fullness, malaise and fatigue. She was suspected to have a viral syndrome with associated headache of non-emergent etiology and was discharged after partial improvement in response to a conventional analgesic regimen. She returned with worsening symptoms and was subsequently discovered to have acute angle closure glaucoma (AACG) by tonometry and sinusitis by Computed Tomography. The patient's intraocular pressures improved with standard AACG therapies. She was continued on these medications at discharge in combination with amoxicillin for presumed bacterial sinusitis.
Why should an emergency physician be aware of this?
Sinusitis and AACG have overlapping symptoms and can co-occur. Thus, AACG should be considered in a patient that presents with symptoms suggestive of sinusitis with an associated ocular complaint. Further study should seek to measure the relationship between these two diseases and investigate potential causal links.
Case report, Sinusitis, Glaucoma, Acute angle closure glaucoma, Blurry vision.
Disclaimer
This research was supported (in whole or in part) by HCA Healthcare and/or an HCA Healthcare affiliated entity. The views expressed in this publication represent those of the author(s) and do not necessarily represent the official views of HCA Healthcare or any of its affiliated entities.
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