Suppurative (bacterial) sinusitis

Upper respiratory tract (viral) infection is the most common predisposing cause of suppurative sinusitis. Acute disease is manifested by pain, nasal discharge, systemic manifestations, and nasal obstruction. In chronic disease (greater than 3 months' duration) nasal airway obstruction and postnasal discharge may be the only symptoms. Diagnosis is made on the basis of the history and physical examination, supported by roentgenographic findings and, if necessary, cultures. Acute infection is treated with antibiotics, decongestants, and analgesics. If medical management fails, surgery is necessary. Complications of suppurative sinusitis include cellulitis, abscess, meningitis and cavernous sinus thrombosis, osteomyelitis, and oroantral fistula.