The main symptoms of acute frontal sinusitis are local pain, a nasal d
ischarge, and nasal obstruction. A 13-year-old boy developed frontal s
inusitis with hyperesthesia in the distribution of the trigeminal nerv
e, diplopia, and palsy of the oculomotor nerve. After receiving cefixi
me then amoxicillin plus clavulanic acid, he was admitted because of t
he development of photophobia and vomiting. His symptoms resolved prom
ptly under intravenous therapy with cefotaxime and fosfomycin. He was
discharged after four days with a prescription for ten days of oral pr
istinamycin.