Acute sinusitis: diagnosis and treatment update.

Area of Science:

• Otolaryngology
• Infectious Diseases

Background:

• Acute sinusitis presents differently in adults (fever, facial pain, purulent rhinorrhea) versus children (fever, persistent cough, purulent rhinorrhea).
• Diagnostic tools like sinus transillumination are useful in adults but not children, where maxillary sinus radiographs are indicated.
• Ultrasound shows lower sensitivity than plain radiographs for diagnosing sinusitis in children.

Purpose of the Study:

• To outline diagnostic approaches for acute sinusitis in adults and children.
• To review current and alternative treatment strategies for acute sinusitis.
• To address management of specific sinusitis cases, including nosocomial, immunocompromised, and chronic forms.

Main Methods:

• Review of diagnostic utility of physical examination, sinus radiography, ultrasound, and sinus aspiration cultures.
• Evaluation of antibiotic efficacy, including first-line (amoxicillin) and alternative agents (trimethoprim-sulfamethoxazole, ciprofloxacin).
• Consideration of specific patient populations (nosocomial, immunocompromised) and chronic sinusitis management (irrigation, surgery, endoscopy).

Main Results:

• Maxillary sinus radiographs are indicated for children; ultrasound is less sensitive than radiographs.
• Amoxicillin remains effective first-line therapy; resistance necessitates alternative antibiotics.
• Specialized treatments are required for nosocomial, fungal, and chronic sinusitis cases.

Conclusions:

• Accurate diagnosis of acute sinusitis requires age-specific approaches.
• Antibiotic selection should be guided by treatment response and specific bacterial profiles.
• Management of complex and chronic sinusitis may involve surgical or endoscopic interventions.