Patient complains of facial pain, headache, post-nasal drip, fever. CT scans are even more useful, but should not be done before standard films. Note that mucosal thickening is a very non-specific finding and does not necessarily mean infection. Nasal cultures are of little help. Cultures should be reserved for patients undergoing nasal irrigation, antrectomy or sinus biopsy.
Fungal cultures are important in chronic sinusitis.
Broad spectrum antibiotics are important. Many of the organisms produce penicillinase, thus a drug like augmentin may be a good therapeutic choice. Guaifenesin with or without decongestants can be useful in keeping sinuses drained. Intranasal steroids can be effective with allergic etiologies, as can oral antihistamines. In acute sinusitis, explain need to complete antibiotic therapy course to prevent recurrence.