Acute and Chronic Sinusitis: The Daily PANCE Blueprint
A 34-year-old female presents to your clinic complaining of nasal congestion, greenish nasal discharge, and facial pressure for the past 12 days. She said her symptoms have been getting progressively worse. You suspect a bacterial sinus infection. Which of the following is most likely to cause this infection?
A. Streptococcus pneumoniae
B. Moraxella catarrhalis
C. Staphylococcus aureus
D. Pseudomonas aeruginosa
E. Klebsiella pneumoniae
Answer and topic summary
The answer is A. Streptococcus pneumoniae
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. The main distinction between viral and bacterial rhinosinusitis is the length of symptoms (bacterial infection lasts longer > 10 days). Management includes analgesics, antipyretics, intranasal steroids (especially if the patient also has allergies), and antibiotics if a bacterial infection is suspected (e.g., Augmentin, amoxicillin, etc.).
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Smarty PANCE Content Blueprint Review:
Covered under ⇒ PANCE Blueprint EENT ⇒ ⇒
Also covered under PAEA Family Medicine and Emergency Medicine Rotation EOR topic list
