sinusitt

Sinusitt, or sinusitis, is an inflammation of the mucous membranes of the paranasal sinuses and the nasal cavities. It can involve one or more sinuses and is commonly categorized by duration: acute sinusitis lasts up to four weeks, subacute from four to twelve weeks, and chronic longer than twelve weeks. Recurrent acute sinusitis refers to several episodes within a year.

Most cases begin after a viral upper respiratory infection. Acute sinusitis may be caused by bacterial infection in some patients, with common organisms including Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. Chronic sinusitis is typically related to ongoing inflammation driven by conditions such as allergic rhinitis, nasal polyps, asthma, structural abnormalities, immune dysfunction, or environmental irritants. Fungal involvement is implicated in certain chronic forms.

Symptoms vary but commonly include facial pain or pressure, nasal congestion, nasal discharge that may be purulent, reduced sense of smell, and cough. Fever can occur with acute illness. Diagnosis is usually based on history and physical examination. Imaging or nasal endoscopy is considered when symptoms persist, recur, or there are complications or suspected structural issues.

Treatment focuses on symptom relief and addressing the underlying cause. Most acute sinusitis is viral and does not require antibiotics. Management typically includes saline nasal irrigation, intranasal corticosteroids, analgesics, and adequate fluids. Antibiotics are considered when a bacterial infection is likely. Chronic sinusitis may require longer-term nasal steroids, treatment of contributing conditions, and sometimes surgical intervention to improve sinus drainage.

Prognosis is generally good with appropriate care, though chronic sinusitis can be persistent. Prevention emphasizes infection control, management of allergies, avoidance of irritants, and vaccination where appropriate.