Acute Rhinosinusitis Flashcards
What is the most common aetiology of acute rhino sinusitis?
Viral
What organisms commonly cause bacterial rhino sinusitis?
Strep pneumoniae
Haemophillus influenzae
Moxarella catrrhalis
Beta-haemolytic strep
How can viral and bacterial acute rhino sinusitis be differentiated from the history?
Viral - lasts <10 days, symptoms peak early and gradually resolve
Bacterial - symptoms present for >10 days without improvement
What are the potential signs and symptoms of rhino sinusitis?
Purulent or clear nasal discharge Nasal obstruction Facial pain or pressure (worse on bending forward) Sore throat Fever Myalgia
What investigations are required in rhino sinusitis?
None required
Nasendoscopy is useful if available
Culture if refractory to ABx, concerned about resistance or immunocompromised
CT/MRI/X-ray if complications suspected
How is viral rhino sinusitis managed?
Rest and hydration Warm Facial packs Nasal saline irrigation Analgesics / antipyretics Decongestants Intransal steroids
When should patients with acute rhino sinusitis be referred to ENT?
Immunocompromised Suspected complication CN deficit Refractory to Abx Recurrent (>4 episodes in a year) Suspected allergic component
For how long should treatment be trialled prior to reassessment in viral rhino sinusitis?
5-10 days
What are the potential complications of rhino sinusitis?
Chronic sinusitis Bacterial meningitis Subdural abscess Peri-orbial or orbital cellulitis Subperiosteal abscess or orbital abscess Cavernous sinus thrombosis
