ACUTE VIRAL RHINOSINUSITIS
DEFINITION:
It is an acute viral infection of lining nasal mucosa characterized by sudden onset of two or more symptoms
one of which must include nasal blockage/obstruction/congestion, or anterior nasal discharge/posterior nasal drip
± Facial pain/pressure
± Reduction of loss of smell for less than 12 weeks
This differs in children in that they should have sudden onset of two or more of the following symptoms:
● Nasal blockage/obstruction/congestion
● Or discolored discharge
● Or cough (daytime and night time)
ETIOLOGY:
Airborne viruses, mainly rhinoviruses and coronaviruses. Other viruses include adenovirus, influenza and parainfluenza
viruses, respiratory syncytial virus and enterovirus. Incubation period is 1-4 days and resolution occur within 7-10 days
PATHOGENESIS:
The viruses attach to the host cells → Normal ciliary action is disrupted → the mucosa becomes very congested and
mucus glands over-secrete → congestion extends to the paranasal sinuses → sinus ostia are blocked → s/s of ARS
SIGN & SYMPTOMS:
● Irritation in ● Sneezing ● Watery rhinorrheab ● Nasal obstructionc
● Head & body ached ● Sense of pressure & heaviness on cheek ● Low grade fevere
TREATMENT:
● Anti histaminea,b ● Nasal decongestantc ● Analgesic & Antipyreticd,e ● Steam inhalation
ACUTE BACTERIAL RHINOSINUSITIS
DEFINITION:
Acute inflammation of nasal lining mucosa, usually follows Viral URTI.
ETIOLOGY:
Streptococcus pneumoniae, Streptococcus pyogenes, Haemophilus influenzae, Moraxella catarrhalis and Staphylococcus.
PAHOGENESIS:
Viral attaches to host cell → ciliary function is disrupted → mucosa congested & edematous → mucus gland oversecrete
→sinus ostia obstructed → stasis of secretion in sinus → nidus for bacterial growth → ABRS
SIGN & SYMPTOMS:
● Discolored mucus, predominantly from one side, with mucopus within the nasal cavity
● Severe local pain, mainly on one side ● Pyrexia >38°C ● Elevated CRP/ESR
● ‘Double sickening’, referring to deterioration after an initial milder phase of illness
TREAMENT:
● Analgesics ● Antibiotics (Amoxicillin/erythromycin) ● Intranasal steroids ● Antihistamine
● Decongestants (0.1% xylometazoline) ● Saline irrigation (with tincture benzoin)
● FESS (in complicated cases)
COMPLICATION:
● Osteitis ● Orbital complication (cellulitis/abscess) ● Chronic Infection
● IC complication (meningitis, extra/sub Dural abscess, cavernous sinus thrombosis)
DEFINITION:
It is an acute viral infection of lining nasal mucosa characterized by sudden onset of two or more symptoms
one of which must include nasal blockage/obstruction/congestion, or anterior nasal discharge/posterior nasal drip
± Facial pain/pressure
± Reduction of loss of smell for less than 12 weeks
This differs in children in that they should have sudden onset of two or more of the following symptoms:
● Nasal blockage/obstruction/congestion
● Or discolored discharge
● Or cough (daytime and night time)
ETIOLOGY:
Airborne viruses, mainly rhinoviruses and coronaviruses. Other viruses include adenovirus, influenza and parainfluenza
viruses, respiratory syncytial virus and enterovirus. Incubation period is 1-4 days and resolution occur within 7-10 days
PATHOGENESIS:
The viruses attach to the host cells → Normal ciliary action is disrupted → the mucosa becomes very congested and
mucus glands over-secrete → congestion extends to the paranasal sinuses → sinus ostia are blocked → s/s of ARS
SIGN & SYMPTOMS:
● Irritation in ● Sneezing ● Watery rhinorrheab ● Nasal obstructionc
● Head & body ached ● Sense of pressure & heaviness on cheek ● Low grade fevere
TREATMENT:
● Anti histaminea,b ● Nasal decongestantc ● Analgesic & Antipyreticd,e ● Steam inhalation
ACUTE BACTERIAL RHINOSINUSITIS
DEFINITION:
Acute inflammation of nasal lining mucosa, usually follows Viral URTI.
ETIOLOGY:
Streptococcus pneumoniae, Streptococcus pyogenes, Haemophilus influenzae, Moraxella catarrhalis and Staphylococcus.
PAHOGENESIS:
Viral attaches to host cell → ciliary function is disrupted → mucosa congested & edematous → mucus gland oversecrete
→sinus ostia obstructed → stasis of secretion in sinus → nidus for bacterial growth → ABRS
SIGN & SYMPTOMS:
● Discolored mucus, predominantly from one side, with mucopus within the nasal cavity
● Severe local pain, mainly on one side ● Pyrexia >38°C ● Elevated CRP/ESR
● ‘Double sickening’, referring to deterioration after an initial milder phase of illness
TREAMENT:
● Analgesics ● Antibiotics (Amoxicillin/erythromycin) ● Intranasal steroids ● Antihistamine
● Decongestants (0.1% xylometazoline) ● Saline irrigation (with tincture benzoin)
● FESS (in complicated cases)
COMPLICATION:
● Osteitis ● Orbital complication (cellulitis/abscess) ● Chronic Infection
● IC complication (meningitis, extra/sub Dural abscess, cavernous sinus thrombosis)
