Bacterial infections account for one of the most important causes of morbidity and mortality after solid organ transplantation. Though the timeline is not fixed, infections may follow a probable outline after transplant. However, being exposed to highly vigorous anti-rejection therapies increases the risk of invasive disease in this special patient population. It may alter the typical clinical presentation and the expected course, leading to misuse of unnecessary treatment regimens that further render antibiotic resistance and medication side effects and interactions. Conversely, common infections may occur mimicking those that are known to be life threatening. It is of difficult management and there must be a fine balance between appropriate antibiotic therapy and immunosuppression to avoid graft rejection. We present the case of a patient who became severely ill resulting from a necrotizing sinusitis initially with cavernous sinus involvement shortly after acute rejection therapy.