Chronic sinusitis is a relatively common diagnosis throughout the US. In patients with an otherwise unremarkable medical history the treatment is typically supportive, requiring only clinical evaluation. We present the case of a 25-year-old male with a history of chronic sinusitis that was brought to our emergency department with new-onset seizure. Three days before he had presented to his usual care facility with two days of headache and fever and was discharged stating headache, subjective fever, and neck stiffness. After further investigation he was diagnosed with a mixed anaerobic epidural abscess. The evaluation and management of chronic sinusitis are based on the presence of symptoms concerning for complication. Prompt investigation of complicated sinusitis is essential in preventing debilitating and fatal sequelae. Our case study underscores the importance of early diagnosis and appropriate management.

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