Acute sinusitis is an infection lasting less than 4 weeks with complete resolution of symptoms (Ferri, 2018). Sinusitis is considered chronic when inflammation of the paranasal sinuses and nasal cavities lasts for > 12 weeks, with persistent upper respiratory symptoms (Ferri, 2018). Most cases of acute sinusitis have a viral cause and will resolve within 2 weeks without antibiotics (Ferri, 2018). Humidification, application of a hot, wet towel over the face, and hydration can help promote sinus drainage (Ferri, 2018). According to the American Academy of Family Physicians (2015) acute bacterial sinusitis should be diagnosed when signs and symptoms (purulent nasal drainage plus nasal obstruction, facial pain-pressure or both) persist without improvement for at least 10 days or if signs and symptoms worsen within 10 days after initial improvement. If deciding to treat with antibiotics, amoxicillin with or without clavulanate should be prescribed as first-line therapy for 5-10 days (AAFP, 2015).
Treatment of chronic sinusitis could include high-volume saline irrigation with topical corticosteroid therapy as first line treatment (Ferri, 2018). A short course of systemic corticosteroids and a short course of doxycycline should be considered for treatment of chronic sinusitis in the presence of nasal polyps (Ferri, 2018). In some cases when chronic sinusitis is resistant to treatment, patients may be recommended for endoscopic sinus surgery which serves to remove nasal polyps or tissue to enlarge the sinus opening and promote drainage (Mayo Clinic, 2018).
1Discuss how this case can develop into chronic disease management?
2What was the evidence that supported the intended outcomes for this patient scenario?
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