Symptoms that have been present for less than 1 month are indicative of acute sinusitis, while symptoms of longer duration reflect chronic sinusitis. Pathophysiology Factors that predispose to sinus infection include anatomic abnormalities, viral URIs, allergies, overuse of topical decongestants, asthma, and immune deficiencies.
Acute sinusitis is associated with the same bacteria as otitis media.
Streptococcus pneumoniae, Hemophilus influenzae, and Moraxella catarrhalis are the most commonly encountered pathogens. Chronic sinusitis is associated with Staphylococcus aureus and anaerobes. If symptoms have lasted for less than 7 to 10 days and the patient is recovering, a self-limited viral URI is the most likely cause. However, worsening symptoms or symptoms that persist for more than 7 days are more likely to be caused by sinusitis. Symptoms of acute sinusitis include facial pain or tenderness, nasal congestion, purulent nasal and postnasal discharge, headache, maxillary tooth pain, malodorous breath, fever, and eye swelling.