Author: Ayesha Dias, Shenaz Nawaz / Editor: Ben Spowage-Delaney, Sarah Edwards / Codes: EP2, SLO4, SLO6 / Published: 09/04/2026
A 56-year-old man presents to the Emergency Department (ED) with nasal obstruction and intermittent fever. He reports a minor fall at work six days prior to the presentation.
On arrival, he is slightly tachycardic but is apyrexial following administration of paracetamol by the ambulance crew. Other vital signs are within normal limits. Systemic examination of the chest, abdomen, throat, and urine are all within normal limits. ENT examination reveals only minimal nasal swelling. A nasal speculum demonstrates boggy swelling in both nasal cavities with intermittent discharge. Blood tests show markedly elevated inflammatory markers, with a C-reactive protein (CRP) level greater than 300.
2 responses
Thanks, this is a common presentation to ED as many patients present after falling.
This is one of the most common presentations in the ED—it was helpful to revisit it again.