A middle-aged man presented with purulent nasal discharge for 3 months, associated with occasional left-sided facial pain. He had no history of fever or cough, and the only co-morbidity was that of chronic asthma, for which he had been on fluticasone and ventolin inhalers for years.
He had seen a number of doctors with no real subsequent improvement, even after short courses of oral antibiotics.
Clinical examination was unremarkable – there was no overlying maxillary tenderness. A CT of the sinuses was ultimately performed.
- What is the likely underlying diagnosis?
- How can this diagnosis be proven, and how is it managed?