Sinusitis, Acute Uncomplicated

Notes

Thick, colored, or purulent nasal secretions do NOT necessarily indicate bacterial infection

Severe symptoms include fever (T >39ºC/102ºF) AND one or both of:

  • Purulent nasal discharge, and/or

  • Facial pain

Definitions

  • Includes mild to moderate nasal discharge lasting 1-10 days, OR

  • Severe symptoms lasting 1-2 days

  • Persistent illness without improvement for >10 days, OR

  • When severe symptoms last >3 days at the beginning of the illness, OR

  • Worsening symptoms after initially improving from a typical URI that lasted 5-6 days with new fever, headache, and/or increased purulent nasal discharge

Management

  • 5-7 days for most

  • 7-10 days for severe disease, immunocompromised, or after treatment failure

If worsening or no improvement after two courses of antibiotics or if concern for orbital/CNS complications of bacterial sinusitis, order contrast-enhanced CT scan (preferred) or MRI of the paranasal sinuses and refer to the appropriate specialist

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