eMedicine Specialties > Infectious Diseases > HEENT Infections

Sinusitis, Acute: Follow-up

Author: Brian E Benson, MD, Staff Physician, Department of Otolaryngology, St Luke's-Roosevelt Hospital Center; Clinical Instructor, Department of Otolaryngology, Hackensack University Medical Center
Coauthor(s): Linas Riauba, MD, Assistant Professor of Clinical Medicine, Department of Medicine, Section of Infectious Disease, University Hospital, University of Medicine and Dentistry of New Jersey; Tracey Quail Davidoff, MD, Senior Clinical Instructor, Department of Emergency Medicine, Rochester General Hospital
Contributor Information and Disclosures

Updated: Feb 10, 2009

Follow-up

Further Outpatient Care

  • Symptomatic or adjunctive therapies may include the following:
    • Humidification/vaporizer
    • Warm compresses
    • Adequate hydration
    • Smoking cessation
    • Balanced nutrition
    • Nonnarcotic analgesia
  • Antihistamines are not recommended and have not been proven beneficial.

Complications

  • Treatment fails in 10-25% of patients. If this occurs, consider the following:
    • Take a repeat history and perform an additional physical examination; consider an imaging study.
    • Start second-line antibiotics.
  • Approximately 75% of orbital or periorbital infections are the result of extending sinusitis.
  • Untreated, inadequately treated, or partially treated rhinosinusitis may lead to chronic rhinosinusitis, meningitis, brain abscess, or other extra-sinus complications.

Prognosis

  • Approximately 40% of acute sinusitis cases resolve spontaneously without antibiotics.
  • The relapse rate after successful treatment is less than 5%.

Miscellaneous

Medicolegal Pitfalls

  • Failure to recognize and aggressively evaluate and treat in light of the following concurrent diagnoses:
    • HIV infection/AIDS
    • Diabetes
    • Hematologic malignancy
    • Immunocompromise
  • Failure to recognize complications
 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous coauthors Michael Cunningham, DO, and Erhun Serbetci, MD, to the development and writing of this article.



More on Sinusitis, Acute

Overview: Sinusitis, Acute
Differential Diagnoses & Workup: Sinusitis, Acute
Treatment & Medication: Sinusitis, Acute
Follow-up: Sinusitis, Acute
References
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References

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Further Reading

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Keywords

acute sinusitis, rhinosinusitis, acute rhinosinusitis, common cold, seasonal allergy, bacterial infection, flu, Streptococcus pneumoniae, S pneumoniae, Haemophilus influenzae, H influenzae, acute ethmomaxillary sinusitis, rhinitis, subacute sinusitis, subacute rhinosinusitis, maxillary sinusitis, ethmoidal sinusitis, frontal sinusitis, sphenoidal viral sinusitis, bacterial sinusitis, fungal orbital sinusitis, intracranial sinusitis, maxillary rhinosinusitis, ethmoidal rhinosinusitis, frontal rhinosinusitis, sphenoidal viral rhinosinusitis, bacterial rhinosinusitis, fungal orbital rhinosinusitis, intracranial rhinosinusitis, acute viral rhinosinusitis, acute bacterial rhinosinusitis, acute viral sinusitis, acute bacterial sinusitis

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Contributor Information and Disclosures

Author

Brian E Benson, MD, Staff Physician, Department of Otolaryngology, St Luke's-Roosevelt Hospital Center; Clinical Instructor, Department of Otolaryngology, Hackensack University Medical Center
Brian E Benson, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Otolaryngic Allergy, American Academy of Otolaryngology-Head and Neck Surgery, and Sigma Xi
Disclosure: Nothing to disclose.

Coauthor(s)

Linas Riauba, MD, Assistant Professor of Clinical Medicine, Department of Medicine, Section of Infectious Disease, University Hospital, University of Medicine and Dentistry of New Jersey
Linas Riauba, MD is a member of the following medical societies: American Medical Association and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

Tracey Quail Davidoff, MD, Senior Clinical Instructor, Department of Emergency Medicine, Rochester General Hospital
Tracey Quail Davidoff, MD is a member of the following medical societies: American College of Emergency Physicians, American College of Forensic Examiners, American College of Physicians, and American Medical Association
Disclosure: Nothing to disclose.

Medical Editor

Thomas Herchline, MD, Professor of Medicine, Wright State University Boonshoft School of Medicine; Medical Director, Public Health, Dayton and Montgomery County, Ohio
Thomas Herchline, MD is a member of the following medical societies: American College of Physicians, American Society for Microbiology, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Gordon L Woods, MD, Consulting Staff, Department of Internal Medicine, University Medical Center
Gordon L Woods, MD is a member of the following medical societies: Society of General Internal Medicine
Disclosure: Nothing to disclose.

CME Editor

Eleftherios Mylonakis, MD, Clinical and Research Fellow, Department of Internal Medicine, Division of Infectious Diseases, Massachusetts General Hospital
Eleftherios Mylonakis, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, American Society for Microbiology, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

Chief Editor

Burke A Cunha, MD, Professor of Medicine, State University of New York School of Medicine at Stony Brook; Chief, Infectious Disease Division, Winthrop-University Hospital
Burke A Cunha, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

 
 
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