Curriculum · ENT, Ophthalmology, and Dermatology
Acute rhinosinusitis
What it is
Acute rhinosinusitis is inflammation of the sinuses with concurrent inflammation of the nasal mucosa for less than 4 weeks. Classification: acute <4 weeks, subacute 4-8 weeks, chronic >8-12 weeks. The cause is obstruction of the osteomeatal complex, where the sinuses drain to, along with inflammation, impaired ciliary function as in CF or Kartagener, immunodeficiency, trauma, or dental infection. The bacteria are S. pneumoniae, H. influenzae and M. catarrhalis; the viruses rhinovirus, adenovirus and influenza. In children viral is more common, and the maxillary sinus is the most affected.
How it presents
Symptoms follow a URTI: facial pain, pressure or fullness, worse on bending forward, purulent rhinorrhea, nasal obstruction, and a change in smell, taste and voice. On examination there is facial fullness and tenderness, nasal discharge, pyrexia, or a post-nasal drip leading to cough. The major symptoms are PODS: P for facial Pain, pressure or fullness; O for nasal Obstruction; D for purulent or discoloured nasal Discharge; S for hyposmia or anosmia, the sense of Smell. The minor symptoms are headache, halitosis, fatigue, dental pain, cough, and ear pain or fullness.