Sinusitis

Question 1

What is acute sinusitis?

Answer 1

Symptomatic inflammation of the paranasal sinuses, usually followed by a viral respiratory tract infection and is defined by symptoms that last for less than 12 weeks

Question 2

How does acute sinusitis occur?

Answer 2

1. Preceding viral rhinitis or infected dentition causes infection of the paranasal sinuses
2. This causes oedema, inflammation and increased mucus production, causing blockage
3. This allows for secondary bacterial growth and infection

Question 3

What are the most common organisms in acute sinusitis?

Answer 3

• Strep. pneumoniae
• H. influenza
• Strep. pyogenes
• Moraxella catarrhalis

Question 4

How does acute sinusitis present?

Answer 4

• Nasal blockage or discharge
• Facial pain/pressure
• Headache
• Hyposmia

Question 5

What are some symptoms that indicate secondary bacterial infection of the sinuses?

Answer 5

Severe pain and tenderness with purulent nasal discharge

Question 6

What are some management options used in acute sinusitis?

Answer 6

• Analgesics
• Nasal decongestants
• Saline irrigation

Question 7

What is a management option in acute sinusitis that has had no improvement after 10 days?

Answer 7

High-dose nasal corticosteroid

Question 8

When should antibiotics be given in acute sinusitis?

Answer 8

In severe or deteriorating sinusitis lasting more than 10 days

Question 9

What 1st line antibiotic is used in acute sinusitis (When required)?

Answer 9

Phenoxymethylpenicillin

Question 10

What 2nd line antibiotic is used in acute sinusitis (When required)?

Answer 10

Doxycycline (Contraindicated in children)

Question 11

What are some possible complications of acute sinusitis?

Answer 11

• Orbital cellulitis
• Periosteal abscess
• Orbital abscess
• Thrombosis of retinal vein or cavernous sinus