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Christmas DA et al. - A 42-year-old man presented with a 2-year history of foul-tasting postnasal drainage. He said that the drainage would resolve temporarily after he was given an antibiotic by his family physician, only to recur after several months. More recently, when the drainage was more bothersome, he would also notice a dull pain at the occiput. The occipital headache would also improve after a course of an antibiotic. He had no significant nasal discharge and no facial pain.On examination, the nose was unremarkable. However, computed tomography of the sinuses showed an almost complete opacification of the larger right sphenoid sinus and a fluid level in the smaller left sphenoid sinus.

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