Sinusitis, also known as rhinosinusitis, is commonly caused by viruses. Viruses initially infect nasal mucosa then spread to paranasal sinuses (see picture). Interestingly, nose blowing may propel infected nasal fluid into sinuses.
In 0.5 to 2 percent of viral sinusitis cases, bacteria impose more complicated infection. The most common bacteria are Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. It may be difficult to tell viral from bacterial sinusitis, since existing clinical criteria are not reliable. Abnormal vision, swelling of eyes, or confusion are worrisome symptoms that require urgent referral to specialists.
Sinus CT scan is not helpful in differentiating between viral and bacterial sinusitis. CT may help exclude diagnosis of sinusitis if there are no evidence of edema or gaseous bubbles. Sinus CT should be done without contrast.
Antibiotics are indicated for bacterial sinusitis, but not recommended for viral cases.
No comments:
Post a Comment