Symptomatic inflammation of the paranasal sinuses, usually followed by a viral respiratory tract infection and is defined by symptoms that last for less than 12 weeks
Aetiology
Most commonly preceded from rhinitis, but can spread from dentition
Most common organisms include strep. pneumonae, H. infuenzae and Moraxella catarrhalis
Clinical presentation
In adults, it is diagnosed by the presence of nasal blockage or nasal discharge with facial pain/pressure (or headache) and/or reduction of the sense of smell
Severe pain and tenderness with purulent nasal discharge indicates secondary bacterial infection
Investigations
Clinical diagnosis
Management
Analgesics and nasal decongestants
Saline irrigation
Consider prescribing a high-dose nasal corticosteroid if a person has had symptoms for around 10 days or more with no improvement
Antibiotics for severe/deteriorating cases of >10 days duration - treat secondary bacterial infection
Phenoxymethylpenicillin first line
Doxycycline second line - contraindicated in children
Complications
Spread of infection into important structures
Spread of infection from sinuses to orbit - cellulitis, periosteal abscess, orbital abscess
Thrombosis of retinal vein or cavernous sinus - infection spreads into superior saggital sinus and patient becomes very unwell
Made with Bullet