Sinusitis

Chirag N. Shah, MD, FACEP and Patrick J. Rogers, DO Reviewed 06/2018

BASICS

DESCRIPTION

Acute sinusitis is a symptomatic inflammation of ≥1 paranasal sinuses of <4 weeks’ duration resulting from impaired drainage and retained secretions accompanied by obstruction, fa...

DIAGNOSIS

History and physical exam suggest and establish the diagnosis but are rarely helpful in distinguishing bacterial from viral causes.
Use a constellation of symptoms rather than a particular si...

TREATMENT

Most cases resolve with supportive care (treating pain, nasal symptoms). Antibiotics should be reserved for symptoms that persist >10 days, onset with severe symptoms (high fever, purulen...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

Return if no improvement after 72 hours or no resolution of symptoms after 10 days of antibiotics.

PATIENT EDUCATION

REFERENCES

Chow AW, Benninger MS, Brook I, et al; for the Infectious Diseases Society of America. IDSA clinical practice guideline for acute bacterial rhinosinusitis in children and adults. Clin Infe...

ADDITIONAL READING

Aring AM, Chan MM. Acute rhinosinusitis in adults. Am Fam Physician. 2011;83(9):1057–1063. [View Abstract on OvidMedline]
Wilson JF. In the clinic. Acute sinusitis. Ann Intern...

CODES

ICD10

J01.90 Acute sinusitis, unspecified
J01.00 Acute maxillary sinusitis, unspecified
J01.20 Acute ethmoidal sinusitis, unspecified
J32.9 Chronic sinusitis, unspecified
J32.8 Other chronic sinusiti...

CLINICAL PEARLS

When bacterial infection is present, patients recover somewhat more quickly with antibiotics, but the majority will recover with symptomatic treatment alone, and accurate diagnosis of ...

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