Chronic sinusitis
From IDWiki
Background
- Sinusitis lasting for at least 12 weeks
- May or may not be infectious
Microbiology
- The microbiology is of unclear significant
- The same bacteria as in acute bacterial sinusitis may be present, especially during acute exacerbations
- Other bacteria include Staphylococcus aureus, Gram-negative bacteria, anaerobes, coagulase-negative staphylococci, and Corynebacterium
Risk Factors
- Systemic factors: viral infection, allergic inflammation, cystic fibrosis, immune disorders, ciliary dyskinesia, tobacco smoke
- Mechanical factors: choanal atresia, deviated septum, nasal polyps, foreign body, tumour, ethmoid bullae
- Local factors: facial trauma, swimming and diving, rhinitis medicamentosa, nasal intubation
Clinical Manifestations
- Symptoms of rhinosinusitis lasting for more than 12 weeks
- Can include nasal discharge, nasal obstruction, facial pain, hyposmia or anosmia, and dysgeusia
Management
- Treat acute exacerbations as acute bacterial sinusitis
- Large-volume nasal rinses are likely helpful
- Antihistamines should be used if underlying allergic disease
- Decongestants may be helpful
- Antihistamines and decongestants should be avoided in children due to the lack of known benefits and risks
- Depending on the underlying risk factors, sinus surgery may be beneficial
