Description Sinusitis is the in...
Description
Sinusitis is the inflammation or infection of the sinuses. The sinuses are cavities in the facial portion of the skull, and lined by mucosa. Sinusitis is the inflammation or infection of these sinuses. It develops most frequently in the maxillary sinuses (under the eyes) and the ethmoid sinuses. In more serious infections the infection can involve the bone (osteomyelitis). Rarely the infection can extend into the brain and be life threatening.
Symptoms
Pain in the face, cough, fatigue, fever, headache, pain behind the eyes, toothache, facial tenderness, nasal congestion and discharge, sore throat, postnasal drip.
Tests
Common tests used for diagnosis and treatment
Workup:
A history and physical exam will be performed. At times a CT scan or MRI will be done.
Tests:
Culture
Other Specific Tests: CT scan, MRI scan
Do I need this test?
Don't order sinus computed tomography (CT) or indiscriminately prescribe antibiotics for uncomplicated acute rhinosinusitis. Viral infections cause the majority of acute rhinosinusitis and only 0.5 percent to 2 percent progress to bacterial infections. Most acute rhinosinusitis resolves without treatment in two weeks. Uncomplicated acute rhinosinusitis is generally diagnosed clinically and does not require a sinus CT scan or other imaging. Antibiotics are not recommended for patients with uncomplicated acute rhinosinusitis who have mild illness and assurance of follow-up. If a decision is made to treat, amoxicillin should be first-line antibiotic treatment for most acute rhinosinusitis.
Specialists:
Internal Medicine, Pediatrics, Family Practice, Ear, Nose, and Throat (ENT)
Workup:
A history and physical exam will be performed. At times a CT scan or MRI will be done.
Tests:
Culture
Other Specific Tests: CT scan, MRI scan
Do I need this test?
Don't order sinus computed tomography (CT) or indiscriminately prescribe antibiotics for uncomplicated acute rhinosinusitis. Viral infections cause the majority of acute rhinosinusitis and only 0.5 percent to 2 percent progress to bacterial infections. Most acute rhinosinusitis resolves without treatment in two weeks. Uncomplicated acute rhinosinusitis is generally diagnosed clinically and does not require a sinus CT scan or other imaging. Antibiotics are not recommended for patients with uncomplicated acute rhinosinusitis who have mild illness and assurance of follow-up. If a decision is made to treat, amoxicillin should be first-line antibiotic treatment for most acute rhinosinusitis.
Specialists:
Internal Medicine, Pediatrics, Family Practice, Ear, Nose, and Throat (ENT)
Treatment
Sinusitis from allergy is treated with antihistamines, nasal sprays, decongestants or allergy shots. Sinus infections caused by viruses do not require antibiotics but are treated with: acetaminophen (Tylenol), nonsteroidal anti-inflammatory medications/NSAIDs (ibuprofen/Motrin or Advil, naproxen/Naprosyn), and decongestants. Bacterial sinusitis will be treated with antibiotics including: amoxicillin (Amoxil), cefaclor (Ceclor), levofloxacin (Levaquin), loracarbef (Lorabid), clarithromycin (Biaxin), azithromycin (Zithromax), or sulfamethoxazole/trimethoprim (Bactrim, Septra).