- Acute sinusitis is an inflammation of the paranasal sinuses usually due to a viral infection, but secondary bacterial infection can occur.
- Often precipitated by an upper respiratory infection.
- Inflammation causes swelling of the mucosa leading to obstruction and reduced clearance of mucus.
- Common bacterial pathogens include: S. pneumoniae, H.influenzae, and Moraxella cattarrhalis.
- Same bacterial etiology as those for otitis media.
Symptoms and Signs
- Pain and pressure over affected sinuses
- Worse when bending forward
- Tenderness to palpation
- Nasal congestion and obstruction
- Purulent nasal discharge
- Transillumination of the affected sinuses may demonstrate opacification
- Usually diagnosed clinically.
- Acute bacterial sinusitis should be considered with persistent symptoms lasting longer than 10 days, severe onset of symptoms, or if symptoms worsen.
- CT scan if complications are suspected or in refractory cases.
- Rules out intracranial or orbital involvement.
- Supportive therapy
- NSAIDs, warm compresses, decongestants, nasal saline irrigation, intranasal corticosteroids
- Antibiotics if symptoms persist for 10-14 days or severe symptoms/signs are present.