Case 56 – the beginning

James a 48 year old painter presents to his GP with facial pain over his right cheek and a blocked nose with rhinorrhoea. James
is given antibiotics for probable sinusitis. Three weeks later his symptoms are worse; he has constant rhinorrhoea, severe facial pain and has noted a small ulcer on his hard palate.

Who would you consider referral to given the presentation?

What further tests would you order given his presentation?

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