Rhinosinusitis is a topic covered in the Washington Manual of Medical Therapeutics.

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General Principles

  • Acute rhinosinusitis is most frequently caused by upper respiratory viruses. Bacterial pathogens, such as S. pneumoniae, H. influenzae, Moraxella catarrhalis, and anaerobes are involved in <2% of cases and should be considered only if symptoms persist for >10 days. In immunosuppressed patients, fungal causes (i.e., Mucor, Rhizopus and Aspergillus species) should be considered.
  • Chronic rhinosinusitis may be caused by any of the etiologic agents responsible for acute sinusitis, as well as S. aureus, Corynebacterium diphtheriae, and many anaerobes (e.g., Prevotella spp., Veillonella spp.). Possible contributing factors include asthma, nasal polyps, allergies, or immunodeficiency.

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