B. Staph. Aureus
Xray Water’s View showing air-fluid level in right maxillary sinus suggestive of Right sided acute Maxillary Sinusitis.
INFECTING ORGANISM CAUSING ACUTE SINUSITIS
- Viral:Rhinovirus,parainfluenza virus,respiratory synctial virus.
S. pneumoniae and nontypable Haemophilus influenzae are the most common pathogens, accounting for 50-60% of cases.
Moraxella catarrhalis causes disease in a signigicant percentage (20%) of children but less often in adults
CLINICAL FEATURES OF ACUTE SINUSITIS
The clinical symptoms of acute sinusitis have been classified into major and minor.
- Facial pain or pressure
- Purulent nasal discharge
- Nasal congestion
- Nasal obstruction
- Hyposmia or Anosmia
- Facial congestion or fullness
- Dental pain
- Ear pain or pressure.
Characteristic findings of Acute Sinusitis
- Headache – usually localized to the occiput or vertex. Pain may also be referred to the mastoid region.
- Isolated involvement of sphenoid sinus is rare. It is often a part of pansinusitis or is associated with infection of posterior ethmoidal sinus.
- The reason for sphenoid sinus to be least affected is that it opens high up in the sphero ethmoid recess which is not affected by most of the conditions of nose
Maxillary sinus :
- Along the infraorbital margin and referred to upper teeth or gums on affected side (along the distribution of superior orbital nerve).
- Pain is aggravated on stooping or coughing.
- Most common sinusitis in adults is Maxillary.
- On rhinoscopy :pus or mucopus in in the middle meatus.
- Tenderness is elicited at canine fossa.
Frontal sinus :
- Pain localized over forehead.
- It has a characteristic periodicity-Office headache
- Tenderness elicited above the medial canthus.
Ethmoid sinus :
- Pain localized over the nasal bridge, inner canthus and behind the ear.
- Most common sinusitis in children is Ethmoid.