Acute sinusitis is an inflammation of the sinuses that usually lasts 2-4 weeks and is often caused by a viral cold. It presents with thick nasal discharge, nasal congestion, and facial pain. Risk factors include allergies, nasal abnormalities, and smoking. Diagnosis involves medical history, exam, and sometimes imaging tests or nasal cultures. Treatment focuses on relieving symptoms with saline rinses, nasal corticosteroids, decongestants, and over-the-counter pain relievers. Antibiotics may be used if a bacterial infection develops.
3. TYPES
Types
Acute sinusitis usually starts with cold like symptoms such as a runny, stuffy
nose and facial pain. It may start suddenly and last 2-4 weeks.
Subacute sinus inflammation usually lasts 4 to 12 weeks.
Chronic inflammation symptoms last 12 weeks or longer.
Recurrent sinusitis happens several times a year.
4. RISK FACTORS
Hay fever or another allergic condition that affects sinuses
A nasal passage abnormality, such as a deviated nasal septum, nasal
polyps or tumors
A medical condition such as cystic fibrosis or an immune system disorder
such as HIV/AIDS
Exposure to smoke, either from smoking or through secondhand smoke
exposure
5. ETIOLOGY
Acute sinusitis is most often caused by the common cold, which is a viral
infection. In some cases, a bacterial infection develops.
6. CLINICAL MANIFESTATION
Acute sinusitis symptoms often include:
Thick, yellow or greenish discharge from the nose or down the back of the
throat (postnasal drainage)
Nasal blockage or congestion, causing difficulty breathing through your
nose
Pain, tenderness, swelling and pressure around your eyes, cheeks, nose or
forehead that worsens when bending over
7.
8. Conti…
Other signs and symptoms include:
Ear pressure
Headache
Aching in your teeth
Altered sense of smell
Cough
Bad breath
Fatigue
Fever
9. DIAGNOSTIC TEST
History
Physical examination
Nasal endoscopy. A thin, flexible tube (endoscope) with a fiber-optic light
inserted through your nose allows your doctor to visually inspect the inside of
your sinuses.
Imaging studies. A CT scan shows details of your sinuses and nasal area. It's not
usually recommended for uncomplicated acute sinusitis, but imaging studies
might help find abnormalities or suspected complications.
Nasal and sinus samples. Laboratory tests aren't generally necessary for
diagnosing acute sinusitis. However, when the condition fails to respond to
treatment or is worsening, tissue samples (cultures) from your nose or sinuses
might help find the cause, such as a bacterial infection.
Allergy testing. If your doctor suspects that allergies have triggered your acute
sinusitis, he or she will recommend an allergy skin test. A skin test is safe and
quick, and can help pinpoint the allergen that's causing your nasal flare-ups.
10. MANAGEMENT
•Saline nasal spray, which you spray into your nose several times a day to rinse your
nasal passages.
•Nasal corticosteroids. These nasal sprays help prevent and treat inflammation.
Examples include fluticasone (Flonase Allergy Relief, Flonase Sensimist Allergy Relief,
others), budesonide (Rhinocort Allergy), mometasone (Nasonex) and beclomethasone
(Beconase AQ, Qnasl, others).
•Decongestants. These medications are available in over-the-counter (OTC) and
prescription liquids, tablets and nasal sprays. Use nasal decongestants for only a few
days. Otherwise they may cause the return of more-severe congestion (rebound
congestion).
•OTC pain relievers, such as acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin
IB, others) or aspirin.