Case 188

Medical history

Female child, 5 years old, was hospitalized for 15 days due to pneumococcal meningitis, during which reported hearing loss on the left. Is diagnosed with asthma and allergic rhinitis with important nasal discharge on the right. Makes constant use of nasal corticosteroids, with little response. Born at term, appropriate weight for the gestational age, vaccination up to date. Prior history of hospitalization for community-acquired pneumonia at age two, and two episodes of meningitis at 14 months and 2 years of age, without sequelae. The mother also reported frequent episodes of bacterial sinusitis and denies previous surgery, history of trauma or other comorbidities.

Analyzing the images and clinical data presented, what is the most likely diagnosis?

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