Case 1 Sinusitis Flashcards
This type of sinusitis lasts < 4 weeks
Acute rhinosinusitis
This type of sinusitis lasts for 4 - 12 wks
Subacute rhinosinusitis
This type of sinusitis lasts > 12 wks
Chronic rhinosinusitis
This type of sinusitis has ≥4 episodes per year, with interim symptom resolution
Recurrent acute rhinosinusitis
This type of sinusitis Symptoms > 10 days (without improvement)
Bacterial
Bacterial or viral sinusitis?
- Unilateral maxillary sinus/facial pain
- Maxillary tooth pain
- Unilateral purulent nasal discharge
- Second sickening
- Fever
Bacterial
Bacterial or viral sinusitis?
- Lasts less than 10 days and improves around day 5-7
- sudden onset
- Affects entire body
Viral
Name the pathogens in acute bacterial sinusitis from most to least common
- S. pneumo
- H flu
- M cat
- S. aureus
1st line therapy for Bacterial Sinusitis?
1st line therapy: Amoxicillin/clavulanate (Augmentin)
If patients are allergic to amox/clav, what med do you give?
doxy
How long should adults take abx for sinusitis?
5 - 7 days
How long should kids take abx for sinusitis?
7 - 10 days
What is some symptomatic therapy for sinusitis?
-Analgesics/antipyretics NSAIDs & Tylenol -Saline irrigation/nasal spray -Intranasal glucocorticoids Flonase -Oral or nasal decongestants -Sudafed, Afrin -Vicks
Name this complication of sinusitis?
Swelling & erythema of periorbital area and eyelids, but no proptosis or limitation of eye movement
Preseptal cellulitis
Name this complication of sinusitis?
Periorbital swelling, eyelid erythema, pain with eye movements, conjunctival swelling (chemosis), proptosis, limitation of eye movements (ophthalmoplegia), diplopia, vision loss
Orbital cellulitis
Name this complication of sinusitis?
Above s/s of orbital cellulitis- marked globe displacement is suggestive
Orbital subperiosteal abscess
Name this complication of sinusitis?
Bilateral ptosis, proptosis, ophthalmoplegia, periorbital edema, headache, mental status changes
Septic cavernous sinus thrombosis
Name this complication of sinusitis?
fever, headache, nuchal rigidity, mental status changes
Meningitis
Name this complication of sinusitis?
Pott puff tumor. Forehead or scalp swelling and tenderness, headache, photophobia, fever, vomiting, lethargy
Osteomyelitis of the frontal bone associated with a subperiosteal abscess
Name this complication of sinusitis?
papilledema, focal neurologic signs, headache, lethargy, n/v
Epidural abscess
Name this complication of sinusitis?
fever, severe headache, meningeal irritation, progressive neurologic deficits, seizures, papilledema, vomiting
Subdural abscess:
Name this complication of sinusitis?
headache, stiff neck, mental status changes, vomiting, focal neurologic deficits, 3rd and 6th cranial nerve deficits, papilledema
Brain abscess
Whats the mc cause/pathogen for sinusitis?
A. S. aureus B. Rhinovirus C. H flu D. S. pneumo E. M. cat
B. Rhinovirus
If a patient had a fever from viral sinusitis what day would it be on?
Day 2
Viral URI symptoms peak between which days?
Day 3 - 6
