acute rhinosinusitis Flashcards
what is acute rhinosinusitis ?
acute inflammation of the mucosal lining of the nasal cavity and paranasal sinuses
what are the viral pathogens that can cause acute rhinosinusitis ?
rhinovirus
coronavirus
parainfluenza virus
respiratory syncytial virus
what are the bacterial pathogens that can cause acute rhinosinusotis ?
strep pneumonia
haemophilus influenza
moraxella catarrhalis
what is the criteria for the diagnosis of acute rhiinosinusitis ?
there is sudden onset of two or more symptoms , one of these symptoms has to be :
nasal blockage/obstruction/congestion
or
nasal discharge whether anterior or posterior nasal drip
+/- facial pain/pressure
+/- reduction or loss of smell for less than 12 weeks
what are the general symptoms associated with acute rhinosinusitis ?
fever and malaise
nasal obstruction
discharge ( which is watery in the beginning, coloured in bacterial)
facial pain/ headache
hyposmia/anosmia
double sickening
what are the signs associated with acute rhinosinusitis ?
fever
facial tenderness ,may be present although uncommon
anterior rhinoscopy: mucosal congestion, discharge
on endoscopy: pus discharging from sinus opening
where do the paranasal sinuses drain ?
into the middle meatus
where is the middle meatus of the nose located ?
between the middle turbinate and the lateral nose of the wall
what are the complications associated with acute rhinosinusitis ?
intracranial: meningitis
Extracranial: osteomyelitis, orbital or preseptal cellulitis, orbital abscess
what are the investigations for a case of acute rhinosinusitis ?
CBC, CRP, ESR
swab for culture and sensitivity if not responding
what is the treatment for Acutee rhinosinusitis if the symptoms have only been present for 5 days and are mild ?
analgesia and nasal saline irrigation
fluid rehydration
nasal decongestant for 1 week only ( xylometazoline os pseudonephrine )
what are the types of nasal decongestants ?
pseudoephidrine
xylometazoline
what is the problem with using xylometazoline for more than 7 days ?
may cause rebound congestion
it should also be avoided in patients with hypertension
what is the treatment for AR that is persistent in symptoms after 10 days or worsening after 5 days ?
analgesia and nasal saline irrigation
fluid rehydration
nasal decongestant for 1 week only
add
topical intranasal steroids
when do we call a case of acute rhinosinusitis severe ?
must have at least 3 of:
discoloured discharge
severe local pain
fever
elevated ESR/CRP
double sickening
