Clinical QuickieInfectious Disease
URI / Acute Sinusitis
Most early upper-respiratory syndromes are viral.
Time course is the discriminator
Viral symptoms commonly improve over days. Persistent symptoms without improvement, severe onset, or 'double worsening' can increase suspicion for bacterial sinusitis.
Color is not the diagnosis
Purulent nasal discharge can occur with viral infection; color alone does not establish bacterial disease.
Treat symptoms appropriately
Analgesics, hydration, saline, and selected intranasal therapies may help depending on the syndrome and patient.
Avoid reflex antibiotics
Antibiotics should follow a bacterial pattern and patient-specific risk rather than duration of one or two days or mucus appearance.
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