Diagnosis of acute rhinosinusitis (original) (raw)
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Inflammation of the nasal mucosa and paranasal sinuses
Polski Przegląd Otorynolaryngologiczny
Inflammation of the paranasal sinuses is a common condition that affects the upper respiratory tract. The pathomechanism and course of sinusitis are multifaceted, depending on the etiological factors, duration of the disease, anatomical abnormalities, and additional conditions exacerbating the inflammation of the nasal mucosa and paranasal sinuses. The gold standard of diagnostic imaging is computed tomography (CT), performed in particular cases. An auxiliary examination is a magnetic resonance imaging (MRI) for soft tissue imaging when there is a suspicion of a neoplastic process. The treatment of patients with rhinosinusitis is very complex and long-lasting, associated with the use of nasal or systemic corticosteroids, irrigation with physiological saline, as well as antibiotic therapy, antihistamines or herbal supplements. The treatment is selected individually for the…
Acute and Chronic Rhinosinusitis, Pathophysiology and Treatment
Acute sinusitis (ARS) and chronic rhinosinusitis(CRS) is a common condition worldwide.CRS is due to the infection and inflammation of paranasal sinuses. Frequent clinical manifestations of ARS include persistent symptoms with nasal discharge or cough or both, presentation with fever accompanies purulent nasal discharge, and worsening symptoms. Complications of CRS have five stages, preseptal cellulitis, orbital cellulitis, subperiosteal abscess, orbital abscess and cavernous sinus septic thrombosis. Most acute sinusitis generally of viral origin, e,g. rhinoviruses, corona viruses,and influenza viruses. Bacterial pathogen include Streptococcus pneumonia, Haemophilus influenza and Moraxella catarrhalis. Bacteria found in biofilms have their antibiotic resistant increased up to 1000 times when compared to bacteria free living of same species. Sinusitis also results from fungal invasion in patients with diabetes, immunedeficiencies, and AIDSor transplant patients. Bacterial and viral si...
Journal of Allergy and Clinical Immunology, 1998
Acute community-acquired sinusitis is considered a bacterial complication of the common cold. Radiologic abnormalities in sinuses occur, however, in most patients with upper respiratory virus infections. Assessment of the occurrence, clinical profile, laboratory findings, and outcome of radiologically confirmed sinusitis was carried out as part of a common cold study in young adults. Clinical examinations and radiography of the paranasal sinuses were carried out on days 1, 7, and 21 in 197 patients with the common cold. The symptoms were recorded on diary cards on days 1 to 20. Ten viruses and 5 bacteria were studied as etiologic agents of common cold as reported earlier. Serum C reactive protein concentrations, erythrocyte sedimentation rates, and total white blood cell counts with differentials were determined in 40 randomized subjects on day 7. The effect of 6 days of intranasal fluticasone propionate treatment of the common cold in the prevention of sinusitis was analyzed. On day 7, 39% of patients with the common cold in the placebo group (n = 98) had sinusitis, which we would prefer to call viral sinusitis. The symptoms of patients with sinusitis and those without it were not clinically distinguishable. Viral infection was detected in 81.6% of patients with sinusitis. No significantly increased levels of antibodies to bacteria were detected. Serum C reactive protein concentrations, erythrocyte sedimentation rates, and white blood cell counts were low in patients with sinusitis. All patients made a clinical recovery within 21 days without antibiotic treatment. Fluticasone propionate treatment tended to prevent paranasal sinusitis, especially in rhinovirus-positive subjects. Viral sinusitis frequently occurs in the early days of the common cold, but it is a self-limited illness. The sinuses should not be imaged in patients with the common cold if the signs and symptoms of illness gradually become less severe and no specific signs suggestive of bacterial sinusitis occur.
Immunology and Allergy Clinics of North America, 2001
Rhinitis and sinusitis are among the most common medical conditions and are frequently associated. In Western societies an estimated 10% to 25% of the population have allergic rhinitis, with 30 to 60 million persons being affected annually in the United States. It is estimated that sinusitis affects 31 million patients annually in the United States. Both rhinitis and sinusitis can significantly decrease quality of life, aggravate comorbid conditions, and require significant direct medical expenditures. Both conditions also create even greater indirect costs to society by causing lost work and school days and reduced workplace productivity and school learning. Management of allergic rhinitis involves avoidance, many pharmacologic options, and, in appropriately selected patients, allergen immunotherapy. Various types of nonallergic rhinitis are treated with avoidance measures and a more limited repertoire of medications. For purposes of this review, sinusitis and rhinosinusitis are synonymous terms. An acute upper respiratory illness of less than approximately 7 days' duration is most commonly caused by viral illness (viral rhinosinusitis), whereas acute bacterial sinusitis becomes more likely beyond 7 to 10 days. Although the mainstay of management of acute bacterial sinusitis is antibiotics, treatment of chronic sinusitis is less straightforward because only some chronic sinusitis cases have an infectious basis. Chronic rhinosinusitis (CRS) has been subdivided into 3 types, namely CRS without nasal polyps, CRS with nasal polyps, and allergic fungal rhinosinusitis. Depending on the type of CRS present, a variety of medical and surgical approaches might be required.
Clinical presentation of acute rhinosinusitis in children reflects paranasal sinus development
Rhinology, 2007
Acute rhinosinusitis (ARS) usually presents with respiratory symptoms that persist for more than 10 days without improving. The aim of the study was to establish whether age may have any influence on the clinical presentation during childhood. This prospective study evaluated 287 consecutive children (152 males and 135 females, aged between 2 and 15 years), in whom mild-moderate ARS was clinically suspected. Nasal endoscopy was performed in all of them to confirm the diagnosis. Endoscopy confirmed clinical diagnosis of ARS in 256 patients (89.2%). The age has shown to have significant influence on the clinical presentation pattern. This study provides evidence that age significantly influences the clinical presentation in children with mild-moderate ARS.