Nonsurgical treatment of sinusitis

Acute infections of the paranasal sinuses is an infrequent complication of viral upper respiratory infections. Prolonged or repeated episodes of acute sinusitis may lead to irreversible changes in the mucosa, resulting in chronic sinusitis. In hospitalized and immunocompromised patients sinusitis may be caused by unusual and resistant bacteria or fungi. Although sinusitis is often considered as merely an annoyance, complications can be associated with significant morbidity and mortality. Therapy of acute sinusitis is often empiric and directed against the most common pathogens. Fungal infections of the sinuses often require surgery as well as amphotericin-B therapy. In hospitalized or immunocompromised patients therapy should be directed at suspected nosocomial pathogens or be based on appropriate culture material.