Last reviewed: June 2019
Last updated: March  2019



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
  • edematous turbinate
  • fever

Risk factors

  • viral upper respiratory tract infection
  • allergic rhinitis
  • GERD

Diagnostic investigations

Investigations to consider

  • nasal endoscopy
  • sinus culture
  • CT sinuses (noncontrast)
  • x-ray sinuses
  • MRI
  • lateral neck x-ray
Full details

Treatment algorithm


Authors VIEW ALL

Gordon H. Sun

Chief Medical Information Officer

Medical Director of Inpatient Services

Chief of Otolaryngology

Rancho Los Amigos National Rehabilitation Center




GHS is a contractor with Medscape from WebMD and a consultant for Partnership for Health Analytic Research, LLC.

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

Peer reviewers VIEW ALL

Instructor of Otology and Laryngology

Harvard Medical School

Massachusetts Eye and Ear Infirmary

Department of Otolaryngology - Head and Neck Surgery




BSB is a co-founder and equity shareholder in Luxxeal, Inc.

Assistant Professor/Consultant

Academic Medical Center


The Netherlands


CG declares that he has no competing interests.

Use of this content is subject to our disclaimer