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Acute sinusitis and rhinosinusitis in adults: Clinical manifestations and diagnosis

Peter H Hwang, MD
Zara M Patel, MD
Section Editors
Daniel G Deschler, MD, FACS
Stephen B Calderwood, MD
Deputy Editor
Sheila Bond, MD


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'.)


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 [1].

Classification of rhinosinusitis is based upon symptom duration (figure 2) [2]:

Acute rhinosinusitis – Symptoms for less than four weeks

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Literature review current through: Nov 2017. | This topic last updated: Nov 08, 2016.
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