From the Guidelines
To diagnose a sinus infection, look for symptoms like facial pain or pressure, nasal congestion, thick yellow or green nasal discharge, reduced sense of smell, and headache lasting more than 7-10 days, as these are the most common indicators of acute sinusitis 1. When diagnosing a sinus infection, it is essential to consider the duration and severity of symptoms. According to the clinical practice guideline update on adult sinusitis 1, acute sinusitis is likely when there has been up to 4 weeks of cloudy or colored drainage from the nose plus one or both of the following: a stuffy, congested, or blocked nose or pain, pressure, or fullness in the face, head, or around the eyes.
Key Symptoms
- Facial pain or pressure
- Nasal congestion
- Thick yellow or green nasal discharge
- Reduced sense of smell
- Headache lasting more than 7-10 days A healthcare provider can diagnose sinusitis through physical examination, looking in your nose with a light, checking for tenderness over your sinuses, and examining your throat for postnasal drip 1.
Diagnostic Approach
- Physical examination
- Looking in the nose with a light
- Checking for tenderness over the sinuses
- Examining the throat for postnasal drip In some cases, they may order imaging tests like a CT scan or nasal endoscopy for a more detailed view, especially when a complication of ABRS or an alternative diagnosis is suspected 1.
Imaging Tests
- CT scan
- Nasal endoscopy While most sinus infections are viral and resolve on their own within 7-10 days, bacterial infections may be suspected if symptoms worsen after initial improvement or persist beyond 10 days without improvement 1. It is crucial to seek medical attention promptly if symptoms are severe, last longer than 10 days, or include high fever, severe headache, confusion, stiff neck, or vision changes, as these could indicate a more serious condition 1.
From the Research
Diagnosing Sinus Infection
To diagnose a sinus infection, several methods can be employed, including:
- History taking: Understanding the patient's symptoms and medical history is crucial in diagnosing sinusitis 2
- Physical examination: Although a negative physical examination does not rule out the diagnosis, it is essential to exclude anatomic causes of symptoms 2
- Nasal cytology: This can help detect the presence of infection or inflammation in the nasal passages 2
- Imaging tests: Such as radiology and computed tomography (CT) scans can help visualize the sinuses and detect any abnormalities 2
- Nasal endoscopy: Using a flexible or rigid nasal endoscope can help visualize the nasal passages and sinuses 2
Diagnostic Criteria
The diagnosis of sinusitis can be based on a combination of clinical symptoms, physical examination, and diagnostic tests. The symptoms of sinusitis can overlap with other diseases, making diagnosis challenging 2.
Treatment Options
Once a diagnosis of sinusitis is made, treatment options can be considered, including:
- Antibiotics: Such as amoxicillin/clavulanate, azithromycin, and levofloxacin have been shown to be effective in treating acute sinusitis 3, 4, 5
- Dosage and duration: The dosage and duration of antibiotic treatment can vary depending on the severity of the infection and the patient's response to treatment 3, 4, 5
Recent Guidelines
Recent reviews of the medical literature have outlined best practices for clinical diagnoses and management strategies for acute and chronic sinusitis, emphasizing the importance of recognizing and differentiating these conditions to provide appropriate and timely diagnoses and care 6