Rhinosinusitis is inflammation of the paranasal sinuses and nasal cavity. It can result from viral, bacterial, or fungal infections with viral being the most common. Infection extension beyond the sinuses and cavities can result in bacterial rhinosinusitis complications (i.e, periorbital edema, meningitis). Sinusitis affects 1 in 8 adults in the United States and accounts for more outpatient antibiotic prescriptions than any other diagnosis. Sinusitis can be further categorized as acute, subacute, chronic, and recurrent based on symptom duration. Whether viral or bacterial, most cases of uncomplicated acute rhinosinusitis self-resolve with supportive care alone but antibiotic therapy should be considered in certain cases of acute bacterial rhinosinusitis.
Symptoms and Classification of Sinusitis
Cardinal symptoms of Acute Rhinosinusitis (ARS)
Purulent nasal discharge
Decreased sense of smell
Maxillary dental pain
Note: ARS is a clinical diagnosis based on the presence of cardinal symptoms. Distinguishing between a viral or bacterial infection is based more on duration and course of symptomatology. Color of nasal discharge alone has poor predictability for predicting the likelihood of a bacterial sinus infection.
Acute (less than 4 weeks)
Subacute (4 to 12 weeks)
Chronic (>12 weeks)
Recurrent (four episodes lasting <4 weeks with complete symptoms resolution between episodes)
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