Summary
Definition
History and exam
Key diagnostic factors
- symptoms <10 days (acute viral sinusitis)
- symptoms >10 days but <4 weeks (acute bacterial sinusitis)
- symptoms that worsen after an initial improvement (acute bacterial sinusitis)
- purulent nasal discharge
- nasal obstruction
- facial pain/pressure
- severe symptoms at onset (acute bacterial sinusitis)
- dental pain
Other diagnostic factors
- cough
- myalgia
- sore throat
- hyposmia
- oedematous turbinate
- fever
Diagnostic investigations
Investigations to consider
- nasal endoscopy
- sinus culture
- CT sinuses (non-contrast)
- x-ray sinuses
- MRI
- lateral neck x-ray
Treatment algorithm
Contributors
Authors

Chief Medical Information Officer
Chief of Otolaryngology
Rancho Los Amigos National Rehabilitation Center
Downey
CA
Disclosures
GS is a consultant with Partnership for Health Analytic Research, LLC and Gerson Lehrman Group, Inc for medical research and expert opinion work. GS is a contractor with Medscape for WebMD for writing healthcare-related articles.
Dr Gordon H. Sun would like to gratefully acknowledge Dr Melissa A. Pynnonen and Dr Joseph K. Han, previous contributors to this topic.
Disclosures
MAP and JKH declare that they have no competing interests.
Peer reviewers
Instructor of Otology and Laryngology
Harvard Medical School
Massachusetts Eye and Ear Infirmary
Department of Otolaryngology - Head and Neck Surgery
Boston
MA
Disclosures
BSB is a co-founder and equity shareholder in Luxxeal, Inc.
Assistant Professor/Consultant
Academic Medical Center
Amsterdam
The Netherlands
Disclosures
CG declares that he has no competing interests.
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