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Acute rhinosinusitis

Última revisão: 18 Jul 2025
Última atualização: 10 Dec 2024

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • symptoms <10 days (acute viral rhinosinusitis)
  • symptoms >10 days but <4 weeks (acute bacterial rhinosinusitis)
  • symptoms that worsen after an initial improvement (acute bacterial rhinosinusitis)
  • purulent nasal discharge
  • nasal obstruction
  • facial pain/pressure
  • severe symptoms at onset (acute bacterial rhinosinusitis)
  • dental pain
Detalhes completos

Outros fatores diagnósticos

  • cough
  • sore throat
  • hyposmia
  • edematous turbinate
  • fever
Detalhes completos

Fatores de risco

  • viral upper respiratory tract infection
  • allergic rhinitis
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • clinical diagnosis
Detalhes completos

Tests to avoid

  • x-ray paranasal sinuses
Detalhes completos

Investigações a serem consideradas

  • nasal endoscopy
  • sinus culture
  • CT sinuses
  • MRI
  • lateral neck x-ray
  • allergy testing
Detalhes completos

Algoritmo de tratamento

AGUDA

suspected acute viral rhinosinusitis

suspected acute bacterial rhinosinusitis

suspected acute invasive fungal rhinosinusitis

CONTÍNUA

recurrent episodes

Colaboradores

Autores

Gordon H. Sun, MD, MBA, MSc
Gordon H. Sun

Director of Specialty Care

High Desert Regional Health Center

Lancaster

CA

Clinical Associate Professor of Otolaryngology-Head and Neck Surgery

Charles R. Drew University of Medicine and Science

Los Angeles

CA

Declarações

GHS is a contractor for MAXIMUS, Inc.

Agradecimentos

Dr Gordon H. Sun would like to gratefully acknowledge Dr Melissa A. Pynnonen and Dr Joseph K. Han, previous contributors to this topic.

Declarações

MAP and JKH declare that they have no competing interests.

Revisores

Michael S. Benninger, MD

Professor of Otolaryngology Head and Neck Surgery

Cleveland Clinic

Lerner College of Medicine

Cleveland

OH

Declarações

MSB declares that he has no competing interests.

Daniel Merenstein, MD

Director of Research Family Medicine

Georgetown University

Washington, DC

Declarações

DM declares that he has no competing interests.

Amin R. Javer, MD, FRCSC, FARS

Clinical Professor

Division of Otolaryngology

University of British Columbia

Vancouver

Canada

Declarações

ARJ is a consultant for iView Therapeutics, GSK, and Sanofi.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

Rosenfeld RM, Piccirillo JF, Chandrasekhar SS, et al. Clinical practice guideline (update): adult sinusitis. Otolaryngol Head Neck Surg. 2015 Apr;152(2 Suppl):S1-39.Texto completo  Resumo

Orlandi RR, Kingdom TT, Smith TL, et al. International consensus statement on allergy and rhinology: rhinosinusitis 2021. Int Forum Allergy Rhinol. 2021 Mar;11(3):213-739. Resumo

Peters AT, Spector S, Hsu J, et al. Diagnosis and management of rhinosinusitis: a practice parameter update. Ann Allergy Asthma Immunol. 2014 Oct;113(4):347-85.Texto completo

Fokkens WJ, Lund VJ, Hopkins C, et al. European position paper on rhinosinusitis and nasal polyps 2020. Rhinology. 2020 Feb 20;58(suppl s29):1-464.Texto completo  Resumo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
  • Acute rhinosinusitis images
  • Diagnósticos diferenciais

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  • Diretrizes

    • Guide to utilization of the microbiology laboratory for diagnosis of infectious diseases
    • Diagnosis and management of sinusitis in adults and children: 2023 update
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  • Folhetos informativos para os pacientes

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