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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

1
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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