Although one of the most common illnesses encountered in the primary care setting, acute community-acquired bacterial sinusitis (ACABS) can be a challenge to diagnose.
Methods
Existing diagnostic modalities ranging from clinical history to imaging studies used to diagnose ACABS are discussed.
Results
Numerous methods exist but they do not distinguish well between viral and bacterial illness.
Conclusion
Diagnosis of ACABS should primarily be made based on the clinical history. Other modalities provide useful information in select cases.
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References
1.
SokolW.Epidemiology of sinusitis in the primary care setting: Results from the 1999–2000 respiratory surveillance program.Am J Med111: 19S–24S, 2001.
2.
RayN.F.R., BaraniukJ.N., ThamerM.Direct expenditures for the treatment of allergic rhinoconjunctivitis in 1996, including the contributions of related airway illnesses.J Allergy Clin Immunol103: 401–407, 1999.
3.
PiccirilloJ.F., MerrittM.G., and RichardsM.L.Psychometric and clinimetric validity of a 20-itiem Sino-Nasal Outcome Test (SNOT-20).Otolaryngol Head Neck Surg126: 41–47, 2002.
4.
Sinus, and Allergy Health Partnership.Antimicrobial treatment guidelines for acute bacterial rhinosinusitis. Executive summary.Otolaryngol Head Neck Surg123: 1–4, 2000.
5.
McCaigL.F., and HughesJ.M.Trends in antimicrobial drug prescribing among office-based physicians in the United States.JAMA273: 214–219, 1995.
6.
Sinusitis Update Workgroup.The diagnosis and management of sinusitis: A practice parameter update.J Allergy Clin Immunol116: S13–S47, 2005.
7.
DesrosiersM., KlossekJ.M., and BenningerM.S.Management of acute bacterial rhinosinusitis: Current issues and future perspectives.Int J Clin Pract60: 190–200, 2006.
8.
ReillyJ.S.The sinusitis cycle.Otolaryngol Head Neck Surg103: 856–861, 1990.
9.
GwaltneyJ.M.Jr., HendleyJ.O., PhillipsC.D.Nose blowing propels nasal fluid into the paranasal sinuses.Clin Infect Dis30: 387–391, 2000.
10.
GwaltneyJ.M.Jr., ScheldW.M., SandeM.A.The microbial etiology and antimicrobial therapy of adults with acute community-acquired sinusitis a fifteen year experience at the University of Virginia and review of other selected studies.J Allergy Clin Immunol90: 457–462, 1992.
11.
GwaltneyJ.M.Rhinovirus infection in an industrial population II: Characteristics of illness and antibody response.JAMA202: 158–164, 1967.
12.
LindbaekM., and HjortdahlP.The clinical diagnosis of acute purulent sinusitis in general practice—A review.Br J Gen Pract52: 491–495, 2002.
13.
LacroixJ.S., RicchettiA., LewD.Symptoms and clinical and radiological signs predicting the presence of pathogenic bacteria in acute rhinosinusitis.Acta Otolaryngol122: 192–196, 2002.
14.
BergO., and CarenfeltC.Analysis of symptoms and clinical signs in the maxillary sinus empyema.Acta Otolaryngol105: 343–349, 1988.
15.
WaldE.R.Sinusitis in children.N Engl J Med326: 319–323, 1992.
16.
FiremanP.Diagnosis of sinusitis in children: Emphasis on the history and physical exam.J Allergy Clin Immunol90: 433–436, 1992.
17.
WaldE.R.Sinusitis in infants and children.Ann Otol Rhinol Laryngol101: 37–41, 1992.
18.
BrookI., GoochW.M.III, JenkinsS.G.Medical management of acute bacterial sinusitis. Recommendations of a clinical advisory committee on pediatric and adult sinusitis.Ann Otol Rhinol Laryngol182: S2–S20, 2000.
19.
RosensteinN., WilliamsR.P., and GerberM.A.The common cold—Principles of judicious use of antimicrobial agents.Pediatrics101: 181–184, 1998.
20.
HealdA., AuckenthalerR., BorstF.Adult bacterial nasopharyngitis: A clinical entity?J Gen Intern Med8: 667–673, 1993.
21.
PoolM.D.A focus on acute sinusitis in adults: Changes in disease management.Am J Med106: 38S–47S, 1999.
22.
BarberoG.J.Gastroesophageal reflux and upper airway disease.Otolaryngol Clin North Am29: 27–38, 1996.
23.
American Academy of Pediatrics.Subcommittee on the management of sinusitis and committee on quality improvement. Clinical practice guideline: Management of sinusitis.Pediatrics108: 798–808, 2001.
24.
DruceH.M.Diagnosis of sinusitis in adults: History, physical exam, nasal cytology, echo, and rhinoscope.J Allergy Clin Immunol90: 436–441, 1992.
25.
WaldE.R., GuerraN., and ByersC.Upper respiratory tract infections in young children: Duration of and frequency of complications.Pediatrics87: 129–133, 1991.
26.
RachelefskyG.S., and SpectorS.L.Sinusitis and asthma.J Asthma27: 1–3, 1990.
27.
WilliamsJ.W.Jr., and SimelD.L.Does this patient have sinusitis? Diagnosing acute sinusitis by history and physical exam.JAMA270: 1242–1246, 1993.
28.
BenningerM.S., PayneS.C., FergusonB.J.Endoscopically directed middle meatal cultures versus maxillary sinus taps in acute bacterial maxillary rhinosinusitis: A meta-analysis.Otolaryngol Head Neck Surg134: 3–9, 2006.
29.
EvansF.O.Jr., SyndnorJ.B., MooreW.E.Sinusitis of its maxillary antrum.N Engl J Med293: 735–739, 1975.
30.
ZinreichS.J.Radiologic diagnosis of the nasal cavity and paranasal sinuses. In Sinusitis: Pathophysiology and Treatment.DruceH.M. (Ed). New York: Marcel Dekker, Inc., 1993.
31.
EngelsE.A., TerrinN., BarzaM.Meta-analysis of diagnostic tests for acute sinusitis.J Clin Epidemiol53: 852–862, 2000.
32.
ZinreichS.J.Rhinosinusitis: Radiologic diagnosis.Otolaryngol Head Neck Surg117: S27–S34, 1997.
33.
GwaltneyJ.M.Jr., DouglassC.D., MillerR.D.Computed tomographic study of the common cold.N Engl J Med330: 25–30, 1994.
HarnsbergerH.R., BabbelR.W., and DavisW.L.The major obstructive inflammatory patterns of the sinonasal region seen on screening sinus computed tomography.Semin Ultrasound CT MR12: 541–560, 1991.
36.
EastC.A., and AnnisJ.A.Preoperative CT scanning for endoscopic sinus surgery: A rational approach.Clin Otolaryngol17: 60–66, 1992.
37.
TiedjenK.U., BeckerE., HeimannK.D.Value of B-image ultrasound in diagnosis of paranasal sinus diseases in comparison with computerized tomography.Laryngorhinootologie77: 541–546, 1998.
38.
de BockG.H., Houwing-DuistermaatJ.J., SpringerM.P.Sensitivity and specificity of diagnostic tests in acute maxillary sinusitis determined by maximum likelihood in the absence of an external standard.J Clin Epidemiol47: 1343–1352, 1994.
39.
ZinreichS.J.Imaging of chronic sinusitis in adults: X-ray, computed tomography, and magnetic resonance imaging.J Allergy Clin Immunol90: S445–S451, 1992.
