The acute infection, itself, may be accompanied by low-grade fever, malaise, headache and possibly a cough. The nasal drainage is serous at first, changing to mucopurulent, with resolution within 10 days. High fever and severe facial pain are absent. The mucopurulent material in the nose or posterior oral cavity is not different from that found in prolonged sinusitis and does not byt itself establish a specific diagnosis. The brevity of symptoms is the key diagnostic element.
Treatment consists of close observation and patient education.
Antibiotics should not be used since promotes bacterial resistance. Supportive therapy can include oral or topical decongestants, nasal saline lavage, antipyretics and analgesic medication. The time course for acute bacterial sinusitis is similar to that for acute viral rhinosinusitis, but most accompanying symptoms, including fever, headache, and facial pain, are exaggerated in older children. These symptoms are suggestive and are relative to a particular patient s tolerance and age. The true prevalence of acute bacterial sinusitis among children is unkown.