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Diagnosis of acute sinusitis
Last reviewed: 06.07.2025
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When assessing the clinical picture of the disease, diagnostically significant clinical criteria for acute sinusitis include:
- purulent discharge from the nose;
- flow of purulent discharge down the back wall of the pharynx;
- lack of effect from the administration of intranasal decongestants;
- drip syndrome.
Minor criteria of acute sinusitis include periorbital edema, headache, pain when pressing on the projection points of the paranasal sinuses, pain in the area of the teeth, ears, throat, difficulty breathing, wheezing and fever.
Laboratory diagnostics of acute sinusitis
Laboratory studies include bacteriological studies - cultures of secretions. Cultures of secretions have no diagnostic value, but allow rational and targeted use of antibiotic therapy.
Peripheral blood analysis is performed in severe cases of acute sinusitis and pansinusitis. Characteristic are leukocytosis, neutrophilia with a shift in the leukocyte formula to the left, a slight increase in the erythrocyte sedimentation rate (ESR).
Instrumental methods for diagnosing acute sinusitis
Anterior rhinoscopy is uninformative, especially in the first 2-3 days of the disease. Endoscopy of the paranasal sinuses allows for a more precise diagnosis and localization of the process, but in infants and young children such a study is very difficult.
Radiography of the paranasal sinuses is widely used. It reveals decreased aeration of the sinuses, thickening of the walls, and exudate in the cavities. Currently, ultrasound scanning and tomography of the nasal cavities are being actively introduced, which provide more complete information. A major role is given to radiological examination methods, which some authors consider as the standard for diagnosing acute sinusitis.
Differential diagnosis of acute sinusitis
As a rule, differential diagnostics of acute sinusitis is necessary based on the localization of the process in a particular sinus.
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