Acute Sinusitis - Symptoms, Treatment Of Acute Bilateral Purulent Sinusitis

2024 Author: Rachel Wainwright | [email protected]. Last modified: 2023-12-15 07:39

Acute sinusitis

The content of the article:

1. Causes and risk factors
2. Forms of the disease
3. Stages
4. Symptoms of acute sinusitis
5. Diagnostics
6. Treatment of acute sinusitis
7. Possible complications and consequences
8. Forecast
9. Prevention

Acute sinusitis (maxillary sinusitis) is an acute inflammatory disease of the mucous membrane of the maxillary (maxillary) sinus.

The right and left paranasal sinuses are air cavities in the bones of the skull that communicate with the nasal cavity, therefore, most of the inflammatory processes in them are due to the penetration of the pathogen from the nasal cavity. Less commonly - through the blood or odontogenic (due to diseases of the upper teeth located close to the maxillary sinus). Inflammation leads to the development of edema, the swollen mucous membrane practically blocks the communication between the sinus and the nasal cavity. Violation of the outflow of mucus becomes the cause of its stagnation, which further increases the inflammation, up to the development of a purulent process. Inflammation can spread to periorbital tissues, periosteum, and bone tissue.

Acute sinusitis is the most common pathology of the paranasal sinuses and one of the most common ENT diseases. Children of the first years of life do not get sick with acute sinusitis due to the structural features of the maxillary sinuses.

Symptoms of acute sinusitis

Causes and risk factors

Acute sinusitis is an infectious disease. The main pathogens are Staphylococcus aureus (Staphylococcus aureus), pneumococcus (Streptococcus pneumoniae), Haemophilus influenzae, viruses (rhinoviruses, coronaviruses, influenza viruses, parainfluenza, etc.).

Diseases and conditions contributing to the development of acute sinusitis:

• curvature of the nasal septum;
• all types of rhinitis;
• ARVI;
• allergic diseases;
• medical manipulations (nasogastric tube, etc.);
• diseases of the upper teeth;
• decreased immunity.

Forms of the disease

Acute sinusitis, depending on the etiological factor:

• viral;
• bacterial;
• allergic;
• fungal;
• post-traumatic;
• vasomotor.

By the type of inflammatory process:

• acute catarrhal sinusitis;
• acute purulent sinusitis.

Depending on the prevalence:

• acute unilateral (left-sided or right-sided) sinusitis;
• acute bilateral sinusitis.

Acute sinusitis can be unilateral or bilateral

Acute bilateral sinusitis is more difficult than unilateral, but less common.

Stages

During acute sinusitis, three stages are distinguished:

1. Initial, or subacute.
2. Acute, or stage of advanced clinical manifestations.
3. Chronization, i.e. the transition of an acute process into a chronic (unfavorable) or recovery (favorable).

Symptoms of acute sinusitis

In the clinical picture of acute sinusitis, local and general symptoms are noted.

Local signs:

• pain in the area of the affected sinus (dull, aching or throbbing, aggravated by tilting the head forward, may be accompanied by a feeling of heaviness, sometimes with irradiation to the temple, forehead);
• nasal congestion, impaired nasal breathing;
• violation (up to the absence) of smell;
• nasal voice;
• bad breath;
• discharge from the nose of a mucopurulent or purulent nature (with acute purulent sinusitis);
• photophobia, eye redness, watery eyes on the affected side.

Intense headache, aggravated by tilting the head - one of the symptoms of acute sinusitis

Common symptoms of acute sinusitis:

• deterioration in general health;
• intense headache;
• an increase in body temperature to febrile values (38 ° C and above);
• irritability;
• sleep disorders;
• loss of appetite; etc.

Diagnostics

To make a diagnosis, they collect complaints, anamnesis, and an objective examination. In most cases, the clinical picture of acute sinusitis is typical and allows a diagnosis to be made based on the data obtained. In order to clarify the diagnosis, an instrumental and laboratory examination is carried out, including the following methods:

• rhinoscopy (visual examination of the nasal cavity using a special mirror, allows you to assess the condition of the mucous membrane and nasal septum);
• radiography;
• computed or magnetic resonance imaging;
• general analysis of blood and urine;
• bacterial culture of nasal discharge with determination of sensitivity to antibiotics (according to indications).

Rhinoscopy allows diagnosing acute sinusitis

Treatment of acute sinusitis

In view of the anatomical location of the maxillary sinuses, i.e., their proximity to the brain, treatment of acute sinusitis is usually carried out in a hospital setting.

Therapeutic measures are aimed at relieving the swelling of the mucous membrane in order to facilitate the removal of the contents from the inflamed sinus, as well as to eliminate the cause that caused the inflammation.

The choice of an anti-infective drug depends on the type of pathogen that caused the inflammatory process (antibacterial, antifungal agents). At the same time, antihistamines, vasoconstrictor drugs, nonsteroidal anti-inflammatory drugs are prescribed.

General treatment is complemented by local therapy: inhalation, rinsing of the nose and maxillary sinuses with antiseptic solutions.

Rinsing the nose is one of the effective methods of treating sinusitis.

In the absence of a positive effect from drug therapy, a puncture (puncture) of the maxillary sinus is performed in order to extract its contents, after which the cavity is washed with an antiseptic solution.

After the acute symptoms subside, at the stage of recovery, physiotherapy is indicated: ultraviolet irradiation, electrophoresis, laser therapy, dynamic currents, etc.

Possible complications and consequences

The most frequent complication of acute sinusitis is its transition to a chronic form, which has a wave-like course (periods of remission are replaced by exacerbations), can last for years and is difficult to treat.

Other complications of acute sinusitis:

• the spread of inflammation to the tissues around the eye and the organ of vision itself;
• phlegmon of the orbit;
• osteomyelitis of the jaw;
• otitis;
• meningitis, meningoencephalitis, etc.

Forecast

With timely adequate treatment, the prognosis is generally favorable. The exception is cases of complications (local or intracranial).

With such complications of advanced acute sinusitis as brain abscess, meningoencephallitis, purulent meningitis, etc., there is a high risk of death.

Prevention

In order to prevent the development of acute sinusitis, the following are recommended:

• timely treatment of respiratory diseases;
• strengthening the immune system (good nutrition, adequate night's sleep, hardening, etc.).
• elimination of the curvature of the nasal septum.

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Anna Aksenova Medical journalist About the author

Education: 2004-2007 "First Kiev Medical College" specialty "Laboratory Diagnostics".

The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!