Risk stratification of severe acute rhinosinusitis unresponsive to oral antibiotics.
CONCLUSIONS
C-reactive protein (CRP) levels may predict the extent of acute rhinosinusitis disease in the computed tomography (CT) scans, as well as the specific symptom severity. High levels may direct the physician to change the treatment.


OBJECTIVE
To establish tools to define 'high risk' patients suffering from acute rhinosinusitis.


METHODS
Patients suffering from severe unresponsive acute rhinosinusitis filled in health-related quality of life questionnaires and rated their symptoms. Blood tests and CT scans were performed. We examined the value of imaging and inflammatory markers, especially CRP, as predictors of disease severity, defined by subjective and objective means; need for surgery; and occurrence of ocular complications.


RESULTS
Thirty-two patients were prospectively recruited. A significant association was found between CRP levels, imaging scores, and symptoms severity. Neither ocular complications nor the need for surgery were present in the group with low CRP level.
Hirshoren
Nir
N
Department of Otolaryngology/Head & Neck Surgery, Hadassah Ein-Kerem University Hospital, Jerusalem, 91120 Israel. drnir@hadassah.org.il
Hirschenbein
Aviv
A
Eliashar
Ron
R
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D012220:Rhinitis / Q000097:blood* / Q000000981:diagnostic imaging* / Q000188:drug therapy; D012307:Risk Factors; D012852:Sinusitis / Q000097:blood* / Q000000981:diagnostic imaging* / Q000188:drug therapy; D014057:Tomography, X-Ray Computed; D017211:Treatment Failure; D055815:Young Adult
D000900:Anti-Bacterial Agents; D015415:Biomarkers; D002097:C-Reactive Protein