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Sinusitis

Chirag N. Shah, MD and Grant Wei, FACEP, MD Reviewed 06/2022
 


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, fac...

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

PROGNOSIS

Alleviation o...

REFERENCES

1
Chow  AW, Benninger  MS, Brook  I, et al; for Infectious Diseases Society of America. IDSA clinical practice guideline for acute bacterial rhinosinusitis in childre...

ADDITIONAL READING

Aring  AM, Chan  MM. Acute rhinosinusitis in adults. Am Fam Physician.  2011;83(9):1057–1063. [View Abstract on OvidMedline]  

CODES

ICD10

  • J01.41 Acute recurrent pansinusitis

  • J01.0 Acute maxillary sinusitis

  • J01.80 Other acute sinusitis

  • J30.9 Allergic rhinitis, unspecified

  • J01.1 Acute frontal sinusitis

  • J01.81 Other acute recurrent s...

CLINICAL PEARLS

  • Most cases resolve with supportive care (treating pain, nasal symptoms).

  • Reserve antibiotics for symptoms that persist >10 days, or if presenting with 3 to 4 consecutive days of seve...

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