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22 Cards in this Set
- Front
- Back
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Most common cause of rhinosinusitis?
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Viral: Rhinovirus, parainfluenza virus, & influenza virus
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Most common bacteria of rhinosinusitis? (2)
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Strep pneumonia & H. influenza.
Followed by M. cat |
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Less common bacteria of rhinosinusitis (5)
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1.) M. cat
2.) Strep pyogenes 3.) staph aureus 4.) g- bacilli 5.) anaerobe |
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What is barotrauma?
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Trauma from a difference in air pressure (deep-sea diving, air travel). This is a risk factor for rhinosinusitis
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Risk factor for abx resistance
a.) age b.) meds c.) places (2) d.) person |
a.) <2 yo or >65 yo
b.) abx use within 4 wks c.) hospitalized within 5 days, daycare d.) immunocompromised |
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Major symptoms of rhinosinusitis
a.) nose (4) b.) face (2) c.) system |
The nose, the face, the system
Nose: Purulent anterior discharge, purulent/discolored posterior discharge, congestion, can't smell (hyposmia/ anosmia) Face: FACIAL Pain/pressure, swelling System: Fever (acute sinusitis only) |
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Minor symptoms of rhinosinusitis
a.) pain (3) b.) mouth (2) c.) system (2) |
Pain, mouth, system
Pain (3): headache, dental pain, earache Mouth (2): halitosis, cough/ scratchy throat System (2): fever (subacute/chronic rhinosinusitis), fatigue |
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Diagnosis of rhinosinusits
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At least 2 major symptoms OR
1 major, 2 minor symptoms |
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Bacterial rhinosinusitis
a.) time frame b.) severe symptoms (3) c.) worsening symptoms (3) |
a.) no improvement of s/sx for 10 days
b.) fever of 102, purulent nasal discharge or pain lasting more than 3-4 days consecutively at the beginning of illness c.) new fever onset, headache, double sickening - after URI of 5-6 days, initially improving, but then had an increase in nasal discharge |
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How long does acute uncomplicated bacterial rhinosinusitis last?
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Less than 30 days
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Acute complicated bacterial rhinosinusitis
a.) what to do b.) people involved c.) symptoms (2) |
a.) refer to a specialist
b.) immunocompromised, have resistance to b-lactams/ abx failure c.) very intense facial pain, CHANGE IN MENTAL STATUS |
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Chronic bacterial rhinosinusitis diagnosis
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inflammation >3months with persistent respiratory problems
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How long does viral sinusitis last?
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7-10 days
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Main difference between viral and bacterial rhinosinusitis
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Time. If symptoms persist for more than 10 days, then it is bacterial. bacterial symptoms are the same as viral symptoms but longer.
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When should you refer a patient to a specialist if they have viral rhinosinusitis? (3)
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1.) risk of complications
2.) vision changes 3.) mental status changes |
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AVOID!!
a.) OTC products (2) and for what type of rhinosinusitis |
Bacterial rhinosinusitis. AVOID
1.) antihistamines (allergra, claritin, zyrtec) 2.) decongestants (sudafed, afrin, neo-synephrine) |
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Nonpharm OTC product treatment (3)
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1.) nasal corticosteroids (for pts with history of allergic rhinitis)
2.) Mucolytics 3.) nasal irrigation |
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Acute bacterial rhinosinusitis (uncomplicated) in ADULTS
a.) first line b.) 2nd line c.) duration of treatment |
a.) augmentin (amoxicillin/ clavulanate) 2-3x/day
b.) doxycycline every day c.) 5-7 days |
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Acute bacterial rhinosinusitis (uncomplicated) in CHILDREN
a.) first line b.) 2nd line c.) duration |
a.) augmentin (covers strep pneumo & h. influenza)
b.) levoquin or clindamycin +cefix/cefpodo c.) 10-14 days |
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Treatment for viral rhinosinusitis
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No prescriptions. Use symptomatic relief bc it resolves on its own. (mucolytics, nasal irrigation, intranasal corticosteroids)
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Pharyngitis
a.) viral cause b.) bacterial cause |
a.) rhinovirus
b.) GABHS: strep pyogenes |
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Age when pharyngitis is most common
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5-15 yo
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