Evidence Based Topic Assignment- Sinusitis
According to JAMA: Sinusitis is defined as inflammation of one or more paranasal sinuses but usually refers to infection of the sinuses. However not all "sinus" complaints are bacterial sinusitis. The gold standard for diagnosing sinusitis, for clinical research, is through sinus aspiration and culture. Among those pt's who were thought to have sinusitis, only 50% actually had the disease based on sinus aspirates. For general practice, the use of radiography through the use of sinus x-rays, CT, or ultrasound, will correctly classify 4 of 5 pts correctly. This has become the reference standard for primary care. This as well as the pt's symptoms are used to diagnose acute bacterial sinusitis. There are 3 "major" and 9 "minor" symptoms used. Major ones being: purulent anterior or posterior nasal drainage or cough. Minor ones: headache, facial pain, periorbital edema, halitosis, tooth pain, increased wheeze, or fever. The presence of 2 or more major symptoms or 1 major and at least 2 minor symptoms are required to be sinusitis. Objectively, the documentation of purulent nasal drainage must be visualized by either the clinician or radiographic evidence. (Simel & Rennie,2009)
Based on current guidelines and research: First, the term rhinosinusitis is now preferred to sinusitis, as inflammation of the sinuses rarely occurs without inflammation of the nasal mucosa as well. As far as the symptoms and radiographs used to diagnose rhinosinusitis, is still standard. Its goes further to classify it into acute viral and acute bacterial rhinosinusitis. *
Acute Viral Rhinosinusitis are symptoms lasting less than 10-14 days are most commonly due to a viral illness and do not require an antibiotic for treatment, as this will not speed up the resolution of the infection. Recommendations are based on getting rest, drinking plenty of fluids, and symptom relief with appropriate medications (Ferguson & Wise,...
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