Acute Sinusitis Questions & Answers

Updated: Mar 01, 2018
  • Author: Itzhak Brook, MD, MSc; Chief Editor: Michael Stuart Bronze, MD  more...
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Questions & Answers

Overview

What are the symptoms of acute sinusitis (sinus infection)?

What are the symptoms of acute bacterial rhinosinusitis (RS)?

What is sinusitis (sinus infection)?

When should acute bacterial sinusitis (sinus infection) be suspected?

What are clinical signs of acute bacterial sinusitis (sinus infection)?

How is acute sinusitis (sinus infection) diagnosed?

What is the role of nasal cytology testing in the diagnosis of acute sinusitis (sinus infection)?

When are immunodeficiency tests indicated in the diagnosis of acute sinusitis (sinus infection)?

When are cultures indicated for the diagnosis of acute sinusitis?

What is the role of imaging studies in the diagnosis of rhinosinusitis (RS)?

How is acute sinusitis (sinus infection) treated?

What are the options for medical drainage of acute sinusitis (sinus infection)?

What are the options for first-line antibiotic therapy for acute sinusitis (sinus infection)?

When are second-line antibiotics indicated for acute sinusitis (sinus infection)?

What are the options for second-line antibiotic therapy for acute sinusitis (sinus infection)?

Which antibiotics are recommended in the treatment of acute sinusitis (sinus infection) based on previous antibiotic use and disease severity?

Which symptomatic or adjunctive therapies may be considered for acute sinusitis (sinus infection)?

How is sinusitis (sinus infection) characterized?

How is rhinosinusitis (RS) classified?

How is acute sinusitis (sinus infection) diagnosed?

What are the primary goals in the treatment of acute sinusitis (sinus infection)?

When is evaluation by an otolaryngologist indicated for acute sinusitis (sinus infection)?

What is the definition of acute rhinosinusitis (RS)?

Over what timeframe do the paranasal sinuses develop?

How do the paranasal sinuses develop during gestation?

How are the paranasal sinuses structured?

What is the composition of the anterior and posterior ethmoid sinuses?

How is the blood supplied and lymphatic drainage accomplished in the paranasal sinuses?

What is the drainage path of the sinuses?

How is sinus drainage maintained?

What is the function of the paranasal sinuses?

How does infection develop in the sinuses?

What causes sinusitis (sinus infection)?

Can healthy sinuses be colonized with bacteria?

Which factors are involved in the pathophysiology of rhinosinusitis (RS)?

How does the ostia become blocked?

What systemic diseases are predisposing risk factors for sinusitis (sinus infection)?

Does immunodeficiency increase the risk for sinusitis (sinus infection)?

Which mechanical obstructions may lead to ostial blockage and sinusitis (sinus infection)?

How do obstructed sinuses lead to sinusitis (sinus infection)?

What is the role of ciliary function in the pathogenesis of sinusitis (sinus infection)?

What factors can lead to impaired ciliary function?

What are the layers of the mucous blanket in the paranasal sinus?

What is the role of mucus composition in the pathogenesis of sinusitis (sinus infection)?

What is the pathophysiology of acute sinusitis (sinus infection) in the intensive care setting?

What causes sinusitis (sinus infection)?

Which pathogens cause acute viral rhinosinusitis (RS)?

Which pathogens are responsible for acute nosocomial bacterial rhinosinusitis (sinus infection)?

What is the role of S pneumoniae in the etiology of acute bacterial rhinosinusitis (sinus infection)?

How often does H influenzae cause acute bacterial rhinosinusitis (sinus infection)?

How often does M catarrhalis cause acute bacterial rhinosinusitis (sinus infection)?

Does S aureus cause acute bacterial rhinosinusitis (sinus infection)?

What is the incidence of sinusitis (sinus infection) in the US?

What is the international prevalence of acute sinusitis (sinus infection)?

Which conditions predispose to acute bacterial rhinosinusitis (RS)?

How has pneumococcal vaccine changed the etiology of acute bacterial rhinosinusitis (sinus infection)?

How often do sinus aspirates contain bacteria in acute bacterial rhinosinusitis (sinus infection), and what are the most common isolates?

What are the most common pathogens isolated from maxillary sinus cultures in acute bacterial rhinosinusitis (RS)?

How often are gram-negative organisms, gram-positive organisms, and polymicrobial invasion found on culture in acute bacterial rhinosinusitis (sinus infection)?

What is the etiology of acute invasive fungal rhinosinusitis (RS)?

What is the economic burden of rhinosinusitis (RS)?

What is the prevalence of acute sinusitis (sinus infection) in children?

Is acute sinusitis (sinus infection) more common in males or females?

What is the prognosis of sinusitis (sinus infection)?

Where can patients find information on sinusitis (sinus infection)?

Presentation

What are the symptoms of acute bacterial rhinosinusitis (RS)?

How is acute sinusitis (sinus infection) diagnosed?

What should be the focus of the medical history during evaluation for rhinosinusitis (RS)?

Which medical history findings are relevant for suspected fungal sinusitis (sinus infection)?

Which clinical findings suggest acute sinusitis (sinus infection)?

What duration of respiratory tract infection suggests acute sinusitis (sinus infection)?

When should acute bacterial sinusitis (sinus infection) be suspected during the course of a viral upper respiratory tract infection?

Is it important to distinguish acute bacterial rhinosinusitis (sinus infection) from acute viral or noninfectious rhinosinusitis, and what are the clues for differentiation?

How often is acute bacterial rhinosinusitis (RS) correctly diagnosed?

What is the role of anterior rhinoscopic exam in the diagnosis of acute sinusitis (sinus infection)?

What is the role of endoscopic exam in the diagnosis of acute sinusitis (sinus infection)?

What are the common physical findings of acute sinusitis (sinus infection)?

Is acute sinusitis (sinus infection) common in children?

What physical findings suggest acute bacterial sinusitis (sinus infection) in children?

How often is pediatric acute sinusitis (sinus infection) suspected and diagnosed, and what are the most commonly used treatments?

What does nasal exam consist of in children younger than 6 years with acute sinusitis (sinus infection)?

What are the symptoms of acute ethmoiditis in children?

What are the AAP recommendations for the use of imaging studies in children with suspected acute bacterial sinusitis (sinus infection)?

Which complications may result from sinusitis?

What are mucoceles?

How common is osteomyelitis as a complication of acute sinusitis?

How does acute bacterial sinusitis (sinus infection) cause orbital complications?

How is orbital inflammation due to sinusitis (sinus infection) diagnosed and classified?

Can acute sinusitis (sinus infection) cause intracranial complications?

What are systemic complications of sinusitis (sinus infection)?

DDX

How is cystic fibrosis differentiated from acute sinusitis (sinus infection)?

How is Kartagener syndrome differentiated from acute sinusitis (sinus infection)?

How is Wegener granulomatosis differentiated from acute sinusitis (sinus infection)?

How is ataxia-telangiectasia differentiated from acute sinusitis (sinus infection)?

How is immotile cilia syndrome differentiated from acute sinusitis (sinus infection)?

How are allergies and asthma differentiated from acute sinusitis (sinus infection)?

How is Wiskott-Aldrich syndrome differentiated from acute sinusitis (sinus infection)?

How is yellow-nail syndrome differentiated from acute sinusitis (sinus infection)?

How is Young syndrome (Barry-Perkins-Young syndrome) (sinusitis-infertility syndrome) differentiated from acute sinusitis (sinus infection)?

What are some of the less-common disorders that should be included in the differential diagnoses of acute sinusitis (sinus infection)?

What are the differential diagnoses for Acute Sinusitis?

Workup

What changes were made when the AAP updated its guidelines for the diagnosis and management of acute bacterial sinusitis (sinus infection) in children and adolescents?

What lab tests are recommended by the AAAAI for the diagnosis of acute sinusitis (sinus infection)?

What are the AAO-HNSF diagnostic guidelines for bacterial rhinosinusitis (RS)?

What is the role of imaging studies in the diagnosis of sinusitis (sinus infection)?

What is the role of blood studies in the diagnosis of acute sinusitis (sinus infection)?

When are tests for immunodeficiency indicated in the diagnosis of acute sinusitis (sinus infection)?

How is nasal cytology testing used in the diagnosis of acute sinusitis (sinus infection)?

When is sweat chloride test screening indicated in acute sinusitis (sinus infection)?

When should cultures of nasal secretions be obtained for acute sinusitis (sinus infection)?

Is culture of nasal secretions useful in the diagnosis of acute sinusitis (sinus infection)?

How should nasal cultures be obtained for acute sinusitis (sinus infection)?

Which imaging study is preferred for the diagnosis of rhinosinusitis (RS)?

What is the role of CT scanning in the diagnosis of acute sinusitis (sinus infection)?

How often is CT evidence of sinusitis (sinus infection) associated with viral upper respiratory infections?

What information can CT scanning provide in regard to the development of acute sinusitis (sinus infection)?

When should CT scanning be performed for acute sinusitis (sinus infection)?

Which projections should be included in basic radiographic exam of acute sinusitis (sinus infection)?

Which radiographic findings suggest acute sinusitis (sinus infection)?

What is the role of MRI in the diagnosis of acute sinusitis (sinus infection)?

Is ultrasonography used in the diagnosis of acute sinusitis (sinus infection)?

What is the role of paranasal biopsy in the diagnosis of acute sinusitis?

What is the role of fiberoptic sinus endoscopy in the diagnosis of acute sinusitis?

Treatment

What are the AAP treatment guidelines for acute bacterial sinusitis (sinus infection) in children and adolescents?

What are the Canadian clinical practice treatment guidelines for acute bacterial rhinosinusitis (RS)?

What are the AAO-HNSF treatment guidelines for acute bacterial rhinosinusitis (RS) in adults?

What are the AAO-HNSF guidelines for the symptomatic treatment of acute rhinosinusitis (RS) in adults?

What are the primary goals of management of acute sinusitis (sinus infection)?

How is drainage achieved in acute sinusitis (sinus infection)?

When are sinus puncture and irrigation techniques indicated in the treatment of acute sinusitis (sinus infection)?

When is evaluation by an otolaryngologist indicated for acute sinusitis (sinus infection)?

How is acute sinusitis (sinus infection) treated in the emergency department (ED)?

Are intranasal steroids effective for the treatment of acute sinusitis (sinus infection)?

Are antihistamines effective in the treatment of acute sinusitis (sinus infection)?

What is the role of oral alpha-adrenergic vasoconstrictors in the treatment of acute sinusitis (sinus infection)?

Are topical vasoconstrictors effective in the treatment of acute sinusitis (sinus infection)?

Are mucolytic agents effective for in the treatment of acute sinusitis (sinus infection)?

Are antibiotics effective for the treatment of uncomplicated sinusitis (sinus infection)?

What is the role of systemic antimicrobial therapy in the treatment of bacterial sinusitis (sinus infection)?

Is amoxicillin effective in the treatment of acute sinusitis (sinus infection)?

What is the efficacy of antimicrobial therapy for acute sinusitis (sinus infection)?

What percentage of S pneumoniae strains are penicillin resistant in acute bacterial sinusitis (sinus infection)?

How should antibiotic therapy for acute bacterial sinusitis (sinus infection) be selected?

When is second-line antibiotic therapy indicated for the treatment of acute sinusitis (sinus infection)?

When are IV antibiotics indicated in the treatment of acute sinusitis (sinus infection)?

What adjunctive therapies may be considered for symptomatic treatment of acute sinusitis (sinus infection)?

Are antihistamines an effective treatment for acute sinusitis (sinus infection)?

Which medications are effective for symptomatic treatment of acute sinusitis?

According to the AAAAI, what should be the basis for antibiotic selection in the treatment of acute sinusitis (sinus infection)?

What are the effects of antibiotic therapy in recurrent acute rhinosinusitis (RS)?

Which antibiotics are most effective for bacterial sinusitis (sinus infection)?

What are the indications for surgical treatment of sinusitis (sinus infection)?

What are the surgical options for treating sinusitis (sinus infection)?

When is surgery indicated for acute frontal sinusitis (sinus infection)?

What are the surgical options for treatment of acute maxillary sinusitis (sinus infection)?

How is acute sphenoid sinusitis (sinus infection) treated?

How is acute ethmoid sinusitis (sinus infection) treated?

What are the possible complications of untreated acute sinusitis (sinus infection)?

What are the local complications of sinusitis (sinus infection)?

What are orbital complications of acute bacterial sinusitis (sinus infection)?

How are orbital complications of acute bacterial sinusitis (sinus infection) diagnosed and classified?

How are orbital complications of acute bacterial sinusitis (sinus infection) treated?

What are the possible intracranial complications of acute sinusitis (sinus infection)?

What are the possible systemic complications of acute sinusitis (sinus infection)?

When is otolaryngology consultation for acute sinusitis (sinus infection) indicated?

Guidelines

What are the AAO-HNSF treatment guidelines for acute sinusitis (sinus infection)?

Medications

Which medications are used in the treatment of viral rhinosinusitis (RS)?

Are antibiotics effective for the treatment of sinusitis (sinus infection)?

What are the Sinus and Allergy Health Partnership treatment guidelines for acute bacterial rhinosinusitis (RS)?

Which medications in the drug class Penicillins are used in the treatment of Acute Sinusitis?

Which medications in the drug class Cephalosporins are used in the treatment of Acute Sinusitis?

Which medications in the drug class Macrolides are used in the treatment of Acute Sinusitis?

Which medications in the drug class Fluoroquinolones are used in the treatment of Acute Sinusitis?

Which medications in the drug class Anti-Infectives are used in the treatment of Acute Sinusitis?

Which medications in the drug class Carbapenems are used in the treatment of Acute Sinusitis?

Which medications in the drug class Aminoglycosides are used in the treatment of Acute Sinusitis?

Which medications in the drug class Tetracyclines are used in the treatment of Acute Sinusitis?

Which medications in the drug class Decongestants are used in the treatment of Acute Sinusitis?

Which medications in the drug class Nasal Sprays are used in the treatment of Acute Sinusitis?

Which medications in the drug class Expectorants are used in the treatment of Acute Sinusitis?

Which medications in the drug class Corticosteroids are used in the treatment of Acute Sinusitis?

Which medications in the drug class Anticholinergics are used in the treatment of Acute Sinusitis?