A 58-year-old immunocompetent woman gave a 2-week history of headache, facial pain and fever, without photophobia, nausea or vomiting. Initially, the pain was left-sided retrobulbar and radiated to the vertex. It was dull and intermittent without postural variation but progressively intensified, becoming more constant with nocturnal interference. The pain gradually extended bilaterally to the cheeks, maxillae and frontoparietal regions while remaining predominantly left-sided. Two days before assessment, she had developed horizontal diplopia on left lateral gaze. On examination, her temperature was 38.5 ° C, and there was limited left eye abduction consistent with left sixth nerve palsy. Her other cranial and peripheral nerve function, ears, nose and throat were normal with no signs of meningeal irritation. Blood tests (including blood cultures) were negative. CT scan of the head identified left sphenoid sinus opacification (figure 1A,B; black arrows) with …

中文翻译：

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伴第六神经麻痹的蝶窦曲霉瘤

一名 58 岁免疫功能正常的女性有 2 周头痛、面部疼痛和发烧史，无畏光、恶心或呕吐。最初，疼痛位于左侧球后并放射至顶点。它是沉闷和间歇性的，没有姿势变化，但逐渐加剧，随着夜间干扰变得更加稳定。疼痛逐渐向双侧扩展至面颊、上颌骨和额顶区域，但仍以左侧为主。在评估前两天，她在左侧注视时出现了水平复视。检查时，她的体温为 38.5°C，左眼外展受限，符合左侧第六神经麻痹。她的其他颅神经和周围神经功能、耳朵、鼻子和喉咙都正常，没有脑膜刺激的迹象。血液检查（包括血培养）呈阴性。头部 CT 扫描发现左侧蝶窦混浊（图 1A、B；黑色箭头），...