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SINUSITIS

Inflamed or infected sinuses. Often follows an acute viral URTI. Inflammation of mucous membranes of paranasal sinuses can result from inadequate drainage of sinuses secondary to infection, allergy or obstruction. May present with headache, pyrexia, localised pain (worse when bending forward) and tenderness over involved sinus. Complications, e.g. facial or periorbital cellulitis, are more common in children than in adults.

Acute sinusitis is usually self-limiting. Only about 2% of cases are complicated by bacterial infection, but they are difficult to distinguish from viral infections. Symptoms can last for 2 – 3 weeks, and most people will recover without antibiotics.

An immediate antibiotic prescription should be offered to people presenting at any time who are systemically unwell, have symptoms and signs of a more serious infection, or who are at high risk of complications.  

NICE NG79. Sinusitis (acute): antimicrobial prescribing; 2017 https://www.nice.org.uk/guidance/ng79
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