Acute sinusitis - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Majority of cases of acute rhinosinusitis in adults and children are of viral etiology.
Duration of symptoms more than 10 days often indicates bacterial cause.
Imaging is not required for diagnosis unless complications are suspected.
Condition is usually self-limiting; however, symptomatic therapy should be considered.
Antibiotics are only recommended in select patient groups (e.g., severe disease, persistent or worsening symptoms, or immunocompromised patients) because symptoms often resolve without intervention and there is a risk of antimicrobial resistance.

Nasal endoscopy of the left nasal cavity showing a small polyp and pus in the middle meatus

From the collection of Joseph K. Han

Quick Reference

History & Exam
- Key Factors
- Other Factors
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Diagnostics Tests
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Treatment Options
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Definition

Epidemiology

Etiology

Pathophysiology

Images

Right inferior turbinate and septum are visible prior to decongestant spray
Right middle turbinate and middle meatus are visible after decongestant spray
Left middle meatus with severe edema and purulent secretions
Left middle meatus with healthy mucosa and non-purulent secretions
Nasal endoscopy of the left nasal cavity showing a small polyp and pus in the middle meatus
Computed tomography scan with right ethmoid sinus opacification and adjacent orbital abscess
Noncontrast computed tomography scan of the sinuses showing nonspecific maxillary sinus air-fluid levels
Normal noncontrast computed tomography scan of the sinuses

Citations

Key Articles

Rosenfeld RM, Piccirillo JF, Chandrasekhar SS, et al. Clinical practice guideline (update): adult sinusitis. Otolaryngol Head Neck Surg. 2015 Apr;152(2 Suppl):S1-39.[Abstract][Full Text]
Orlandi RR, Kingdom TT, Smith TL, et al. International consensus statement on allergy and rhinology: rhinosinusitis 2021. Int Forum Allergy Rhinol. 2021 Mar;11(3):213-739.[Abstract]
Peters AT, Spector S, Hsu J, et al. Diagnosis and management of rhinosinusitis: a practice parameter update. Ann Allergy Asthma Immunol. 2014 Oct;113(4):347-85.[Full Text]
Fokkens WJ, Lund VJ, Hopkins C, et al. European position paper on rhinosinusitis and nasal polyps 2020. Rhinology. 2020 Feb 20;58(suppl s29):1-464.[Abstract][Full Text]

Other Online Resources

University of Michigan Health System: saltwater washes (nasal saline lavage or irrigation) for sinusitis

Referenced Articles

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