👂 ENTENT / InfectiousStudentInternResident

Acute Rhinosinusitis (Sinusitis)

Also known as: sinusitis · acute sinusitis

Inflammation of the nose and paranasal sinuses — nasal blockage/congestion, facial pain or pressure, and discharge with reduced smell, usually following a viral URTI. Most cases are viral and self-limiting; only a minority are bacterial.

Source · Reviewed 2026-08-15 · v1.0— AI-assisted draft — verify against the cited guideline before clinical use.

⚕️ Education only — not medical advice. Verify against the latest official guideline and your local protocol; confirm every drug dose against the cited source before clinical use.

Who gets it

After viral colds; risk with allergic rhinitis, smoking, dental infection and anatomical factors.

Red flags — escalate / refer

Periorbital swelling/proptosis or visual change (orbital cellulitis), severe frontal headache with neurology/meningism (intracranial spread), or systemic toxicity → urgent imaging and specialist care.

Work-up / diagnosis

1A clinical diagnosis by symptoms and duration.
2Suspect bacterial infection when symptoms are severe, persist beyond about 10 days, or worsen after initial improvement ('double-sickening'); imaging only for complications or recurrent/chronic disease.

Management — overview

Most (viral) cases need only symptomatic care — analgesia, saline irrigation and intranasal corticosteroids; a short decongestant course can help.
Reserve antibiotics for likely bacterial infection (severe, prolonged, or double-sickening) per antimicrobial guidance.
Urgent referral and IV antibiotics ± surgery for orbital or intracranial complications.

In-depthFull dosing & advanced protocol

Drug dosing

Symptomatic (analgesia, saline, intranasal steroid)

Most (viral) rhinosinusitis

Adult dose: Per protocol
Route: Oral / intranasal

ICMRStandard Treatment Workflows (STWs), India — Dept. of Health Research & ICMR (2022+) ↗

Antibiotics (only if bacterial features)

Severe / >10 days / double-sickening

Adult dose: Per local antimicrobial policy
Route: Oral

ICMRICMR Treatment Guidelines for Antimicrobial Use in Common Syndromes (2019) ↗

Most is viral — avoid antibiotics

Severe symptoms, duration over 10 days, or 'double-sickening' suggest bacterial infection.
Watch for orbital/intracranial complications — these are emergencies.
Intranasal steroids and saline help; decongestants only short-term.

ICMRStandard Treatment Workflows (STWs), India — Dept. of Health Research & ICMR (2022+) ↗

References

Guidelines change. If something here is out of date, tell us — we keep these current.

🚩 Report outdated / suggest update

More protocols

Acute Otitis MediaAn acute middle-ear infection, common in children — ear pain, fever and a bulging, red tympanic membrane. Most are self-limiting; analgesia is the priority.Epistaxis (Nosebleed)Bleeding from the nose — usually anterior (Little's area) and self-limiting, occasionally posterior and serious. First aid controls most; find and treat the cause.Acute Pharyngitis & TonsillitisAcute inflammation of the pharynx/tonsils — sore throat, pain on swallowing, fever and tender neck nodes. Most cases are viral; the key is spotting group-A streptococcal ('strep') throat, which benefits from antibiotics and prevents complications.

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👤 Who gets it

🚩 Red flags — escalate / refer

🔎 Work-up / diagnosis

🧭 Management — overview

💊 Drug dosing

Symptomatic (analgesia, saline, intranasal steroid)

Antibiotics (only if bacterial features)

📈 Most is viral — avoid antibiotics

📚 References

More protocols

👤 Who gets it

🚩 Red flags — escalate / refer

🔎 Work-up / diagnosis

🧭 Management — overview

💊 Drug dosing

Symptomatic (analgesia, saline, intranasal steroid)

Antibiotics (only if bacterial features)

📈 Most is viral — avoid antibiotics

📚 References

More protocols

Who gets it

Red flags — escalate / refer

Work-up / diagnosis

Management — overview

Drug dosing

Most is viral — avoid antibiotics

References

Who gets it

Red flags — escalate / refer

Work-up / diagnosis

Management — overview

Drug dosing

Most is viral — avoid antibiotics

References