By ULY CLINIC
Acute Rhinosinusitis
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Introduction
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It is the inflammation of the mucosal lining of the nose and paranasal sinuses of not more than 12 weeks duration. In sinusitis of dental origin, anaerobic bacteria are often found.
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Acute Purulent Rhinosinusitis
Bacterial infection with pus accumulation in one or more of the paranasal sinuses
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Diagnostic Criteria
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Anterior rhinoscopy – watery/purulent nasal discharge occasionally foul smelling
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Nasal congestion
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Plain paranasal sinuses X ray (Water’s, Caldwell views)
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Mucosal thickening; air fluid levels
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Pharmacological Treatment:
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Phenoxymethylpenicillin (PO) 500mg 8 hourly for 7 days. Children up to 5 years: 6 mg/kg 6 hourly for 10 days
OR
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Azithromycin (PO) 500mg once daily for 3 days. Children: 10mg/kg once daily for 3 days
OR
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Amoxicillin+Clavulanic acid (PO) Adults: 625mg (500mg amoxicillin+125mg Clavulanic acid) 8 hourly for 7 days Children: 375mg (250mg amoxicillin,+125 Clavulanic acid) 12 hourly for 7 days;
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Note: Treatment periods shorter than ten days increase the risk of treatment failure
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Referral: To ENT Specialists
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Children with ethmoiditis presenting as an acute periorbital inflammation or orbital cellulitis must be hospitalized immediately
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Adults with pronounced symptoms despite treatment
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If sinusitis of dental origin is suspected
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Recurrent sinusitis (>3 attacks in a year) or chronic sinusitis (duration of illness of >12 weeks)
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Updated on, 31.10.2020
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References
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1. STG