Acute sinusitis and rhinosinusitis in adults: Clinical manifestations and diagnosis
- Peter H Hwang, MD
Peter H Hwang, MD
- Chief, Division of Rhinology
- Department of Otolaryngology - Head & Neck Surgery
- Stanford University School of Medicine
- Zara M Patel, MD
Zara M Patel, MD
- Assistant Professor
- Division of Rhinology
- Department of Otolaryngology - Head and Neck Surgery
- Stanford University School of Medicine
- Section Editors
- Daniel G Deschler, MD, FACS
Daniel G Deschler, MD, FACS
- Section Editor — Otorhinolaryngology
- Professor of Otology and Laryngology
- Harvard Medical School
- Stephen B Calderwood, MD
Stephen B Calderwood, MD
- Editor-in-Chief — Infectious Diseases
- Section Editor — Bacterial Infections
- Professor of Medicine (Microbiology and Immunobiology)
- Harvard Medical School
Sinusitis and rhinosinusitis refer to inflammation in the nasal cavity and paranasal sinuses. Acute rhinosinusitis (ARS) lasts less than four weeks. The most common etiology of ARS is a viral infection associated with the common cold. Distinguishing acute viral rhinosinusitis related to colds and influenza-like illnesses from bacterial infection is a frequent challenge to the primary care clinician. This topic will address the clinical manifestations and diagnosis of acute viral and bacterial rhinosinusitis. The treatment of acute viral and bacterial ARS is discussed separately. (See "Uncomplicated acute sinusitis and rhinosinusitis in adults: Treatment".)
Acute invasive fungal sinusitis, nosocomial bacterial sinusitis, and chronic rhinosinusitis are discussed separately. (See "Fungal rhinosinusitis", section on 'Invasive fungal sinusitis' and "Chronic rhinosinusitis: Clinical manifestations, pathophysiology, and diagnosis" and "Chronic rhinosinusitis: Management" and "Complications of the endotracheal tube following initial placement: Prevention and management in adult intensive care unit patients", section on 'Sinusitis'.)
DEFINITION AND CLASSIFICATION
Acute rhinosinusitis (ARS) is defined as symptomatic inflammation of the nasal cavity and paranasal sinuses (figure 1) lasting less than four weeks. The term "rhinosinusitis" is preferred to "sinusitis" since inflammation of the sinuses rarely occurs without concurrent inflammation of the nasal mucosa .
●Acute rhinosinusitis – Symptoms for less than four weeks
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- DEFINITION AND CLASSIFICATION
- PATHOPHYSIOLOGY AND MICROBIOLOGY
- Acute viral rhinosinusitis
- Acute bacterial rhinosinusitis
- CLINICAL FEATURES
- Physical findings
- Radiologic features
- DIAGNOSIS AND EVALUATION
- Uncomplicated acute rhinosinusitis
- - Acute viral rhinosinusitis
- - Acute bacterial rhinosinusitis
- - Supportive testing
- Complicated acute bacterial rhinosinusitis
- DIFFERENTIAL DIAGNOSIS
- Acute invasive fungal rhinosinusitis
- The common cold
- SOCIETY GUIDELINE LINKS
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS