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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

  • Anterior rhinoscopy – watery/purulent nasal discharge occasionally foul smelling

  • Nasal congestion

  • Plain paranasal sinuses X ray (Water’s, Caldwell views) 

  • Mucosal thickening; air fluid levels 

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Pharmacological Treatment:  

 

  • Phenoxymethylpenicillin (PO) 500mg 8 hourly for 7 days. Children up to 5 years: 6 mg/kg 6 hourly for 10 days    

OR

 

  • Azithromycin (PO) 500mg once daily for 3 days. Children: 10mg/kg once daily for 3 days     

OR

  • 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

  • Adults with pronounced symptoms despite treatment 

  • If sinusitis of dental origin is suspected

  • 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 

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