Sinusitis

Question 1

What are some symptoms of sinusitis?

Answer 1

-nasal blockage/congestion
-facial pain/pressure
-reduction or loss of sense of smell
-cough
-fever
-sore throat
-hoarseness

Question 2

How can you suspect viral or bacterial cause of sinusitis?

Answer 2

Symptoms more severe in bacterial infection:
-Symptoms for more than 10 days.
-Discoloured or purulent nasal discharge.
-Severe localized pain (often unilateral, particularly pain over teeth and jaw).
-Fever greater than 38°C.
-Marked deterioration after an initial milder phase

Question 3

How long must symptoms be present to diagnose acute viral or post-viral sinusitis?

Answer 3

Acute viral- less than 10 days

Post viral- more than 10 days, worsening of symptoms after 5 days

Question 4

When should sinusitis patients be referred to hospital ?

Answer 4

-A severe systemic infection.

-Signs of sepsis.

-Intraorbital or periorbital complications, including periorbital oedema or cellulitis, a displaced eyeball, double vision, ophthalmoplegia, or newly reduced visual acuity.

-Intracranial complications, including swelling over the frontal bone, symptoms or signs of meningitis, severe frontal headache, or focal neurological signs

Question 5

How can acute sinusitis be managed?

Answer 5

-usually self limiting and doesn’t routinely need abx
-paracetamol and ibuprofen for pain management
-nasal saline or decongestants

Question 6

What safety netting advice would you give to someone with acute sinusitis?

Answer 6

To seek medical advice if symptoms worsen rapidly or significantly, symptoms do not improve after 3 weeks, or they become systemically very unwell