From the Guidelines
Acute sinusitis typically presents with nasal congestion, purulent nasal discharge, facial pain or pressure, and decreased sense of smell, and is usually caused by viral infections, though bacterial superinfection can occur. The clinical presentation of acute sinusitis can vary, but common symptoms include:
- Nasal congestion and obstruction
- Purulent nasal discharge
- Maxillary tooth pain
- Facial pain or pressure
- Fever
- Fatigue
- Cough
- Hyposmia or anosmia
- Ear pressure or fullness
- Headache
- Halitosis These symptoms can last from 1 to 33 days, with most episodes resolving within a week 1. The diagnosis of acute sinusitis is primarily clinical, with imaging reserved for complicated cases, and most cases are viral and self-limiting, improving within 7-10 days with supportive care including saline irrigation, intranasal corticosteroids, and analgesics 1. Antibiotics should be considered only when bacterial infection is suspected based on severe symptoms, prolonged duration, or worsening after initial improvement, and the preferred agents are amoxicillin or amoxicillin-clavulanate 1. It's essential to differentiate between viral and bacterial causes of sinusitis, as most cases are viral and do not require antibiotic treatment, and the overuse of antibiotics can lead to resistance and other complications 1. In summary, the clinical presentation of acute sinusitis is characterized by a combination of nasal, facial, and systemic symptoms, and the diagnosis and management should be guided by clinical criteria, with a focus on supportive care and judicious use of antibiotics.
From the FDA Drug Label
Acute bacterial sinusitis due to Haemophilus influenzae, Moraxella catarrhalis or Streptococcus pneumoniae. The clinical presentation of acute sinusitis is not directly described in the provided drug labels. However, the causative pathogens of acute bacterial sinusitis are mentioned, which include:
From the Research
Clinical Presentation of Acute Sinusitis
The clinical presentation of acute sinusitis is characterized by several key symptoms, including:
- Nasal congestion
- Rhinorrhoea
- Facial pain
- Hyposmia
- Sneezing
- Malaise
- Fever (in more severe cases) 3 Additional symptoms may include unilateral facial pain or pressure, purulent nasal discharge with obstruction of the nasal passages, and fever greater than 102°F (39°C) 4
Diagnostic Considerations
Acute sinusitis is a clinical diagnosis, and distinguishing between bacterial and viral sinusitis can be challenging 4 Diagnostic testing for acute rhinosinusitis, such as antral puncture, is impractical due to its invasiveness 4 Point-of-care testing for elevated C-reactive protein may be helpful, but it is not widely available 4
Epidemiology
Acute sinusitis affects 1-5% of the adult population each year in Europe 3 In the United States, acute rhinosinusitis causes more than 30 million patients to seek health care per year 4