Rhinosinusitis: Types and features
| Clinical features | Acute vs chronic | Complications | |
|---|---|---|---|
| Viral | Symptoms improve Duration < 10 days | ||
| Bacterial | Symptoms persist > 10 days “Double sickening”: symptoms improve, then worsen High fever, then worsening symptoms | Acute: < 4 weeks Subacute: 4–12 weeks Chronic: > 12 weeks Recurrent: 4 or more episodes | Uncomplicated: contained in nasal cavity and sinuses Complicated: spread to orbit, nervous system, surrounding structures |
| Fungal | Seen in immunosuppression, chronic steroid use, diabetes mellitus | Acute: < 4 weeks Chronic: > 4 weeks | Noninvasive: contained within sinuses Invasive: spread beyond sinuses |
| Allergic | Predominance of sneezing, rhinorrhea, nasal congestion and itching | Chronic rhinosinusitis |