Nose and Sinus Disorders: The Daily PANCE Blueprint
A 34-year-old male presents with five days of nasal congestion and facial pressure. He also reports low-grade fever and fatigue. Which of the following is the most common cause of this patient’s condition?
A. Streptococcus pneumoniae
B. Haemophilus influenzae
C. Staphylococcus aureus
D. Rhinovirus infection
E. Moraxella catarrhalis
Answer and topic summary
The answer is D. Rhinovirus infection
Acute rhinosinusitis (ARS) is inflammation of the nasal cavity and paranasal sinuses that lasts for less than 4 weeks. The most common cause is a virus (e.g., adenovirus, rhinovirus, etc). Acute bacterial sinusitis is actually relatively rare (2.0% of all ARS cases) and is usually caused by Streptococcus pneumoniae or Haemophilus influenzae. Clinical features of ARS include nasal congestion, nasal discharge, facial pain/pressure, and even maxillary tooth discomfort. Patients may have other symptoms like fever, fatigue, cough, ear pressure, etc. The main distinction between viral and bacterial rhinosinusitis is the length of symptoms (bacterial infection last longer > 10 days). Management include analgesics, antipyretics, intranasal steroids (especially if patient also has allergies), and antibiotics if a bacterial infection is suspected (e.g., augmentin, amoxicillin, doxycycline if PCN allergy, etc).
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Smarty PANCE Content Blueprint Review:
Covered under ⇒ PANCE Blueprint EENT ⇒ Nose and Sinus Disorders (PEARLS) ⇒ Acute and chronic sinusitis
Also covered under PAEA Family Medicine and Emergency Medicine Rotation EOR topic list
