Rhinosinusitis: Types and features

Clinical featuresAcute vs chronicComplications
ViralSymptoms improve
Duration < 10 days
BacterialSymptoms 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
FungalSeen in immunosuppression, chronic steroid use, diabetes mellitusAcute: < 4 weeks
Chronic: > 4 weeks
Noninvasive: contained within sinuses
Invasive: spread beyond sinuses
AllergicPredominance of sneezing, rhinorrhea, nasal congestion and itchingChronic rhinosinusitis