title: Diagnosis of acute rhinosinusitis.
abstract: Rhinosinusitis is almost always a complication of a viral infection involving the upper respiratory tract. A common cold is the first symptom of rhinosinusitis, but infectious processes involving the nose inevitably affect the paranasal sinuses because of their anatomical contiguity. The symptoms remain those of a common cold as long as nasal phlogosis is moderate and the ostia between the nose and sinuses are patent. If the inflammation is intense, edema may obliterate the ostia and isolate the sinuses, thus stopping the removal of the exudates. The duration of symptoms makes it possible to distinguish acute (10-30 days) from subacute (30-90 days) and chronic rhinosinusitis (>90 days). The diagnosis of rhinosinusitis should only be based on anamnestic and clinical criteria in children with serious or persistent symptoms of upper respiratory tract infection, or which appear within a short time of an apparent recovery. Computed tomography and magnetic resonance images of the paranasal sinuses should be reserved for children reasonably considered to be candidates for surgery. Antibiotics are recommended in cases of mild acute bacterial rhinosinusitis as a means of accelerating the resolution of symptoms. The use of antibiotics is mandatory in severe acute bacterial rhinosinusitis to cure the disease and avoid the possible onset of severe complications.
authors: Department of Maternal and Pediatric Sciences, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 9, Milan, Italy. susanna.esposito@unimi.it
authors: Susanna
authors: S
authors: Esposito
authors: Paola
authors: P
authors: Marchisio
authors: Rossana
authors: R
authors: Tenconi
authors: Laura
authors: L
authors: Tagliaferri
authors: Giada
authors: G
authors: Albertario
authors: Maria Francesca
authors: MF
authors: Patria
authors: Nicola
authors: N
authors: Principi
mesh_terms: D000208:Acute Disease; D002648:Child; D002908:Chronic Disease; D003937:Diagnosis, Differential; D006801:Humans; D008279:Magnetic Resonance Imaging; D010256:Paranasal Sinuses / Q000000981:diagnostic imaging / Q000276:immunology*; D011877:Radionuclide Imaging; D012137:Respiratory System / Q000276:immunology / Q000821:virology; D012220:Rhinitis / Q000175:diagnosis* / Q000209:etiology / Q000276:immunology; D012852:Sinusitis / Q000175:diagnosis* / Q000209:etiology / Q000276:immunology; D014057:Tomography, X-Ray Computed; D014777:Virus Diseases / Q000150:complications / Q000175:diagnosis* / Q000276:immunology