In addition, the presentation of cavernous sinus thrombosis can be similar to the presentation of other causes of headache. [cureus.com]

The predictive value of these signs and symptoms was 81% with 4 predictors present, and it was 92% with all 5 predictors present [16]. However, radiographic studies in general cannot distinguish between viral and bacterial causes of sinusitis. [academic.oup.com]

Patients presenting with these symptoms should be closely monitored. [ajmc.com]

According to the guideline, a sinus infection is likely to be caused by bacteria rather than a virus if any of the three following conditions is present: Symptoms last for at least 10 days without any evidence of clinical improvement Symptoms are severe [clinicaladvisor.com]

Swelling at the front of the head, cheeks or around the eyes occurs Nasal discharge contains blood High fever is present These are indications that the bacterial infection is severe. [ada.com]

• Asymptomatic

  They may be asymptomatic, but larger polyps can block the normal sinus pathways and predispose to sinusitis. They can be caused by long-term inflammation but can also be hereditary. [khealth.ai]

  Her symptoms quickly resolve, and by day 3 of treatment she is asymptomatic. Sinusitis is a common childhood disease which involves inflammation of the paranasal sinuses (frontal, maxillary, ethmoid, and/or sphenoid). [hawaii.edu]

  Occurrence of asymptomatic sinusitis in common cold and other acute ENT-infection, Rhinology, 1986, vol. 24 (pg. 223 - 5 ) 3, ,. [academic.oup.com]

  RARS presents similarly with three or more episodes of acute rhinosinusitis however patients are asymptomatic in between episodes of acute infection. [worldallergy.org]

  One limitation of sinus CT scans is that there is a high frequency of abnormal scans in asymptomatic patients. [2] TREATMENT Sinusitis without signs of bacterial infection Treatment is symptomatic. [straighthealthcare.com]

• Anemia

  Primary immune deficiency includes frequent sinusitis, and/or bronchitis, pneumonias, and/or irritable bowel, and/or blood dyscrasias like anemias and clotting. Please see an allergist immunologist trained in treating recurrent infections. [kallergy.com]

• Frontal Sinus Pain

  sinus pain, fever, sinus tenderness on exam, and purulent pharyngeal discharge have not been shown to be useful in acute bacterial rhinosinusitis diagnosis.7 TABLE Clinical prediction rule for acute bacterial rhinosinusitis Symptoms PPV Local pain, unilateral [mdedge.com]

  sinus pain for 48 hours, presence of pus under rhinoscopy Main exclusion criteria Symptoms 1 month Antibiotics during previous 4 weeks Upper respiratory infection Baseline characteristics Average age 37 years Median length of symptoms - 4.5 days Randomized [straighthealthcare.com]

• Maxillary Sinus Pain

  In one study that used the end points of maxillary sinus pain, C-reactive protein level, and erythrocyte sedimentation rate, a total sample size of 133 patients yielded a type I error of 0.05, a type II error of 0.10, and a minimum detectable effect size [academic.oup.com]

• Persistent Vomiting

  If your child has the following symptoms, call your pediatrician immediately: Swelling and/or redness around the eyes, not just in the morning but all day Severe headache and/or pain in the back of the neck Persistent vomiting Sensitivity to light Increasing [healthychildren.org]

• Fracture

  […] following an organ transplant Diabetes Hormonal changes, for example those that occur during pregnancy Irritating inhalants, such as cocaine Fungal infections Scar tissue in sinus areas, for example from nasogastric tubes or mechanical ventilation Facial fractures [ada.com]

  […] time and do not improve with antibiotics See Mucormycosis Differential Diagnosis Rhinorrhea Upper respiratory infection, influenza Sinusitis Juvenile nasopharyngeal angiofibroma Nasal polyposis Nasal mass Nasal foreign body CSF leak (e.g. basilar skull fracture [wikem.org]

• Hypesthesia

  Patients with bacterial infection of the sphenoid sinus have presented with severe frontal, temporal, or retroorbital headache that radiates to the occipital region and hypesthesia or hyperesthesia of the ophthalmic or maxillary dermatomes of the fifth [meddean.luc.edu]

  Other signs and symptoms considered to be severe and more likely to be due to a bacterial pathogen include; persistent fever altered mental status diplopia infraorbital hypesthesia. [atsu.edu]

• Neglect

  The development of chronic sinus disease is an important and neglected end point that also requires large sample sizes. Randomization, blinding, and compliance. [academic.oup.com]

• Nasal Speech

  Children may experience:[4][6] Irritability Ear discomfort Lethargy Snoring Mouth breathing Difficulty feeding Nasal speech Good to know: Bacterial sinusitis can affect children of any age, even though the paranasal sinuses are not visible on X-ray before [ada.com]

• Cranial Nerve Involvement

  In addition, headache (100%) and cranial nerve involvement (86%) were the two most common presenting symptoms along with fever (71%) and orbital symptoms (71%) [9]. [cureus.com]

The patient had an extensive workup outside the hospital including temporal artery biopsy, CT angiogram of the head and neck which were all reportedly negative. [cureus.com]

Objective/s This article provides an overview of acute and chronic sinusitis, and a guide to workup and management in a primary care setting. Complications and other indications for referral are discussed. [racgp.org.au]

See Workup for more detail. Management Treatment of acute sinusitis consists of providing adequate drainage of the involved sinus and appropriate systemic treatment of the likely bacterial pathogens. [emedicine.medscape.com]

A thorough diagnostic workup should be performed to rule out any underlying conditions, including allergies, asthma, immune system problems, gastroesophageal reflux disorder, and structural problems in the nasal passages. [mountsinai.org]

• Chlamydia

  Streptococcus pneumoniae, Haemophilus influenzae Moraxella catarrhalis S pneumoniae H influenzae M catarrhalis Staphylococcus aureus Streptococcus pyogenes Chlamydia pneumoniae Mycoplasma pneumoniae ABRS occurs when bacteria that colonize the nasopharynx [ajmc.com]

  Chlamydia pneumoniae has been identified in patients with respiratory illness that includes features of sinusitis. Only approximately 60% of sinus aspirates in suspected cases of sinusitis yield bacteria. [meddean.luc.edu]

  Respiratory infection with Chlamydia pneumoniae in middle-aged and older adult outpatients. Eur J Clin Microbiol Infect Dis 1994;13:785–792. Crossref, Medline, Google Scholar 130. Hashigucci K, Ogawa H, Suzuki T, Kazuyama Y. [atsjournals.org]

Placebo recipients with unresolved infection would be offered treatment. [academic.oup.com]

These differences between treatments were not statistically significant. A low incidence of generally mild adverse clinical experiences occurred in both treatment groups. [jamanetwork.com]

Treatment Symptomatic relief is the primary goal in the treatment of viral rhinosinusitis. [ajmc.com]

In severe cases or cases that do not respond to treatment, a nasal endoscopy may be done to aid diagnosis and treatment. [ada.com]

Treatments for ABRS can include: Antibiotics to kill the infecting bacteria Pain medicines Rinsing the nasal passages with saline to make them feel better Researchers don’t know if some of these treatments work for ABRS. [cedars-sinai.org]

J Laryngol Otol. 2002, 116:667-676. 10.1258/002221502760237920 van der Poel NA, Mourits MP, de Win MML, Coutinho JM, Dikkers FG: Prognosis of septic cavernous sinus thrombosis remarkably improved: a case series of 12 patients and literature review. [cureus.com]

Prevention, and Complications Prognosis Generally good in acute bacterial sinusitis can be fatal in diabetic or immunocompromised patients with invasive fungal disease Complications osteomyellitis mucocele meningitis epidural abcess cerebral abscess [step2.medbullets.com]

The black eschar of the palate (necrotic hard-palate lesions that respect the midline) is a hallmark of this disease unfortunately; if no treatment begins before this the patient’s prognosis is poor. [atsu.edu]

Lancet 335:1077-8, 1990 Stern RC, Boat TF, Wood RE, Matthews LW, Doershuk CF: Treatment and prognosis of nasal polyps in cystic fibrosis. [med.stanford.edu]

Predicting prognosis and effect of antibiotic treatment in rhinosinusitis. Ann Fam Med. 2006;4(6):486–93. [PMC free article] [PubMed] [Google Scholar] 20. Institute for Clinical Systems Improvement. Health care guideline: acute sinusitis in adults. [ncbi.nlm.nih.gov]

Table 2 Viral and bacterial etiology of acute sinusitis. Table 2 Viral and bacterial etiology of acute sinusitis. [academic.oup.com]

Cefdinir versus levofloxacin in patients with acute rhinosinusitis of presumed bacterial etiology: a multicenter, randomized, double-blind study. Clinical Therapeutics, 26(12): 2026-2033, 2004. [ti.ubc.ca]

Sinusitis Summary Definition Epidemiology Etiology Pathophysiology Clinical features Subtypes and variants Nasal polyps Primary ciliary dyskinesia Diagnostics Treatment Complications [amboss.com]

The microbial etiology and antimicrobial therapy of adults with acute community-acquired sinusitis: a fifteen-year experience at the University of Virginia and review of other selected studies. J Allergy Clin Immunol. 1992;90;(3 pt 2):457–61. 22. [aafp.org]

Abnormalities visible on the CT scan persisted in 20% of patients at 2 weeks, yet epidemiological studies have shown that acute bacterial rhinosinusitis develops in only 0.5% to 2% of upper respiratory infections in adults. [mdedge.com]

References: [4] Epidemiological data refers to the US, unless otherwise specified. [amboss.com]

“Epidemiology and economic impact of rhinosinusitis”. Ann Otol Rhinol Laryngol Suppl. vol. 193. 2004. pp. 3-5. (This article describes the epidemiology of sinusitis and its economic impact in the United States.) [infectiousdiseaseadvisor.com]

Epidemiology Rhinosinusitis Results in millions of office visits each year. Respiratory viruses cause most cases of acute rhinosinusitis. Symptoms usually resolve within 5–7 days, and most people recover without medical treatment. [atsu.edu]

Epidemiology and burden of nasal congestion. Stewart M, Ferguson B, Fromer L. Int J Gen Med. 2010 Apr 8;3:37-45. 28. De la rhinite allergique aux pathologies sinusiennes (sinusite/polypose) : les liens épidémiologiques et expérimentaux. P. Demoly. [passeportsante.net]

Sinusitis Summary Definition Epidemiology Etiology Pathophysiology Clinical features Subtypes and variants Nasal polyps Primary ciliary dyskinesia Diagnostics Treatment Complications [amboss.com]

(See Anatomy, Pathophysiology, and Etiology.) [emedicine.medscape.com]

Pathophysiology The ostiomeatal complex, the area at the confluence of drainage from the sinuses, is particularly vulnerable to inflammatory changes, swelling, and obstruction. [aafp.org]

Pathophysiology of Sinusitis Irrespective of etiology, 3 key features characterize sinusitis: inflammatory edema of the sinus mucosa, obstruction of the sinus ostia, and decreased mucociliary activity. [academic.oup.com]

By evaluating the respiratory tract as one continuous structure, it becomes easier to understand the underlying pathophysiology and treatment of sinus disease in CF. [med.stanford.edu]

[…] care to prevent the spread of colds or the flu in the home and community can help prevent some cases of bacterial sinusitis. [ada.com]

Sinusitis Prevention To avoid sinusitis, you should be sure to: Wash your hands: Washing your hands can help prevent the spread of germs and colds that can lead to sinusitis Don’t smoke: Smoking can irritate your nose and sinuses Manage your allergies [khealth.ai]

SCHEID, M.D., M.P.H., is associate professor in the Department of Family and Preventive Medicine at the University of Oklahoma Health Sciences Center, Oklahoma City, Okla. [aafp.org]

Although ABRS is usually a self-limited infection, eradication of bacterial pathogens may lead to decreased duration of illness and prevent complications associated with ABRS. [ajmc.com]

Preventing Sinusitis As always, an ounce of prevention is worth a pound of cure. [entsc.com]