Adult Chronic Sinusitis and Its Complications

Acute rhinosinusitis

< 4 wk

> 2 major factors, 1 major factor and 2 minor factors, or nasal purulence on examination

1 major factor or > 2 minor factors

Fever or facial pain does not constitute a suggestive history in the absence of other nasal signs or symptoms

Subacute rhinosinusitis

4-12 wk

Same as chronic

Same as chronic

Consider acute bacterial rhinosinusitis if symptoms worsen after 5 d, if symptoms persist for > 10 d, or in presence of symptoms out of proportion to those typically associated with viral infection

Recurrent acute rhinosinusitis

> 4 episodes/yr with each episode lasting > 7-10 d and absence of signs or symptoms between episodes

Same as acute

Chronic rhinosinusitis

> 12 wk

> 2 major factors, 1 major factor and 2 minor factors, or nasal purulence on examination

1 major factor or > 2 minor factors

Facial pain does not constitute a suggestive history in the absence of other nasal signs or symptoms

Acute exacerbation of chronic rhinosinusitis

Sudden worsening of chronic rhinosinusitis with return to baseline after treatment

*Reprinted with permission from Lanza and Kennedy.¹⁴