Sinusitis resident survival guide: Difference between revisions
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==Causes== | ==Causes== | ||
===Life Threatening Causes=== | ===Life Threatening Causes=== | ||
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated. | |||
* | * Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated. | ||
* There are no known causes of life threatening causes of sinusitis. | |||
===Common Causes=== | ===Common Causes=== | ||
<br /> | |||
Infectious causes of rhinosinusitis include [[viruses]], [[bacteria]], and [[fungi]]:<ref name="pmid21364226">{{cite journal| author=Brook I| title=Microbiology of sinusitis. | journal=Proc Am Thorac Soc | year= 2011 | volume= 8 | issue= 1 | pages= 90-100 | pmid=21364226 | doi=10.1513/pats.201006-038RN | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21364226 }} </ref><ref name="pmid9227932">{{cite journal |vauthors=deShazo RD, Chapin K, Swain RE |title=Fungal sinusitis |journal=N. Engl. J. Med. |volume=337 |issue=4 |pages=254–9 |year=1997 |pmid=9227932 |doi=10.1056/NEJM199707243370407 |url=}}</ref> | |||
* [[ | *Viruses | ||
* [[ | **[[Rhinovirus]] | ||
* [[ | **[[Influenza virus]] | ||
**[[Parainfluenza virus]] | |||
*Bacteria | |||
**[[Streptococcus pneumoniae]] | |||
**[[Haemophilus influenzae]] | |||
**[[Moraxella catarrhalis]] | |||
**[[Streptococcus pyogenes]] | |||
**[[Staphylococcus aureus]]: common in chronic [[sinusitis]] | |||
**[[Pseudomonas aeruginosa]]: common in nosocomial [[sinusitis]], [[cystic fibrosis]] patients and the immunocompromised | |||
**Anaerobes: [[Prevotella]], [[Fusobacterium]] and [[Peptostreptococcus]]: common in chronic [[sinusitis]] | |||
*Fungi | |||
**[[Aspergillus]] species | |||
**[[Fusarium]] species | |||
**[[The Mucorales]] | |||
==Diagnosis== | ==Diagnosis== | ||
Shown below is an algorithm summarizing the diagnosis of | Shown below is an algorithm summarizing the diagnosis of sinusitis according to the American Academy of Otolaryngology guidelines. | ||
{{ | |||
{{ | {{Family tree/start}} | ||
{{ | {{Family tree | | | | | | | | | | | A01 | | | |A01= Adult with possible [[sinusitis]]}} | ||
{{ | {{Family tree | | | | | | | | | | | |!| | | | | }} | ||
{{ | {{Family tree | | | | | |,|-|-|-|-|-|+|-|-|-|-|-|.| }} | ||
{{ | {{Family tree | | | | | A01 | | | | A02 | | | | A03 | A01= Duration ≤ 4w | A02= Duration 4-12w | A03= Duration ≥ 12w }} | ||
{{Family tree | | | | | |!| | | | | |!| | | | | |!| | | | | | }} | |||
{{Family tree | | | | | A01 | | | | A02 | | | | A03 | A01= Meets criteria for [[ acute rhinosinusitis]]? | A02= “Subacute” [[sinusitis]] excluded from guideline | A03= Signs and | |||
[[symptoms]] of [[chronic rhinosinusitis]]? }} | |||
{{Family tree/end}} | |||
==Treatment== | ==Treatment== | ||
Shown below is an algorithm summarizing the treatment of | Shown below is an algorithm summarizing the [[treatment]] of [[sinusitis]] according to the American Academy of Otolaryngology guidelines. | ||
==Do's== | ==Do's== | ||
Revision as of 14:15, 20 August 2020
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Moises Romo M.D.
Overview
Rhinosinusitis is the inflammation of the nasal mucosa and paranasal sinuses. The terms sinusitis and rhinosinusitis are used interchangeably, although rhinosinusitis is preferred because inflammation of the paranasal sinuses rarely ever occurs without concurrent inflammation of the nasal mucosa. The cause of rhinosinusitis is mostly infectious, although it can be associated with other medical conditions such as allergies. The diagnosis is primarily clinical and imaging and other diagnostic studies are not necessary for diagnosis.
Causes
Life Threatening Causes
- Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.
- There are no known causes of life threatening causes of sinusitis.
Common Causes
Infectious causes of rhinosinusitis include viruses, bacteria, and fungi:[1][2]
- Bacteria
- Streptococcus pneumoniae
- Haemophilus influenzae
- Moraxella catarrhalis
- Streptococcus pyogenes
- Staphylococcus aureus: common in chronic sinusitis
- Pseudomonas aeruginosa: common in nosocomial sinusitis, cystic fibrosis patients and the immunocompromised
- Anaerobes: Prevotella, Fusobacterium and Peptostreptococcus: common in chronic sinusitis
- Fungi
- Aspergillus species
- Fusarium species
- The Mucorales
Diagnosis
Shown below is an algorithm summarizing the diagnosis of sinusitis according to the American Academy of Otolaryngology guidelines.
| Adult with possible sinusitis | |||||||||||||||||||||||||||||||||||||||||||||||
| Duration ≤ 4w | Duration 4-12w | Duration ≥ 12w | |||||||||||||||||||||||||||||||||||||||||||||
| Meets criteria for acute rhinosinusitis? | “Subacute” sinusitis excluded from guideline | Signs and symptoms of chronic rhinosinusitis? | |||||||||||||||||||||||||||||||||||||||||||||
Treatment
Shown below is an algorithm summarizing the treatment of sinusitis according to the American Academy of Otolaryngology guidelines.
Do's
- The content in this section is in bullet points.
Don'ts
- The content in this section is in bullet points.
References
- ↑ Brook I (2011). "Microbiology of sinusitis". Proc Am Thorac Soc. 8 (1): 90–100. doi:10.1513/pats.201006-038RN. PMID 21364226.
- ↑ deShazo RD, Chapin K, Swain RE (1997). "Fungal sinusitis". N. Engl. J. Med. 337 (4): 254–9. doi:10.1056/NEJM199707243370407. PMID 9227932.