title: The common cold in patients with a history of recurrent sinusitis: increased symptoms and radiologic sinusitislike findings.
abstract: BACKGROUND
  We evaluated whether the symptoms and signs and radiologic findings during a common cold are similar in patients who have and have not suffered from recurrent sinusitis.
  
  
  METHODS
  We recruited 2 series of volunteer cases from February 1, 1996, to December 31, 1996. Twenty-three adults who claimed to have suffered from recurrent sinusitis and 25 who had never had sinusitis were examined during the period of a self-diagnosed cold of 48 to 96 hours' duration and again after 21 days. Symptom scores were recorded, nasoendoscopy and computed tomography scans were performed, and viral and bacterial specimens were taken.
  
  
  RESULTS
  The patients with a history of sinusitis had significantly higher symptom scores than the control patients (P=.04) and had radiologic sinusitislike changes more often (65% [15] vs 36% [9]; difference 29% [95% confidence interval, 2%-56%]; P=.04). The viral etiology of the common cold (verified in 67% of the episodes) was similar in both groups. Pathogenic bacteria were isolated from the middle meatus in 24% (6) of the control patients and only 9% (2) of the sinusitis-prone patients (P=.15). On the basis of the symptomatology, radiologic findings, and bacterial cultures only 2 patients in the sinusitis-prone group should have been treated with antimicrobials.
  
  
  CONCLUSIONS
  Some patients are susceptible to both sinusitislike symptoms and radiologic findings during viral common colds. This may cause them to consult their physicians earlier and more often during viral colds, which may result in unnecessary antibiotic treatments. Nasopharyngeal bacteriological cultures may prove to be useful in ruling out bacterial sinusitis.
authors.affiliation: Department of Otorhinolaryngology, University of Oulu, Finland. opalho@cc.oulu.fi
authors.forename: O P
authors.initials: OP
authors.lastname: Alho
authors.forename: K
authors.initials: K
authors.lastname: Ylitalo
authors.forename: K
authors.initials: K
authors.lastname: Jokinen
authors.forename: J
authors.initials: J
authors.lastname: Laitinen
authors.forename: I
authors.initials: I
authors.lastname: Suramo
authors.forename: H
authors.initials: H
authors.lastname: Tuokko
authors.forename: M
authors.initials: M
authors.lastname: Koskela
authors.forename: M
authors.initials: M
authors.lastname: Uhari
mesh_terms: D000328:Adult; D003139:Common Cold / Q000150:complications* / Q000000981:diagnostic imaging* / Q000382:microbiology; D005260:Female; D006801:Humans; D008297:Male; D012008:Recurrence; D012852:Sinusitis / Q000150:complications* / Q000000981:diagnostic imaging* / Q000188:drug therapy; D014057:Tomography, X-Ray Computed