Clinical introduction

A female patient aged 78 years with a medical history of hypertension, type 2 diabetes and dyslipidemia, presented with right otalgia. At her first consultation, amoxicillin and clavulanic acid and topical ofloxacin were prescribed after the suggestion of a bacterial infection process, but without improvement of the symptoms. She arrived at our ED 3 days later with an acute onset of impaired facial expression and ocular pain. On physical examination, she was noted to have right conjunctival hyperemia, right-sided …