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Sinusitis

 

Epidemiology

-         associated both bacterial and viral infection

Microbiology

-         S.pneumoniae, H.Influenzae, M.catarrhalis

-         Infrequent

o       S.pyogenes, S.Aureus, Anaerobic bacteria

-         Virus

o       Rhinovirus, influenza virus, adenovirus parainfluenza virus

Signs and symptoms

-         nasal discharge, nasal congestion, facial pain, maxillary toothache, fever

-         the persistence of nasal discharge and a cough for more than 10 days following a viral infection of the upper respiratory tract is indicative of sinusitis.

-         Toothache, poor response to decongestant, colored nasal discharge

Pharmacological therapy

-         Amoxicillin 500mg three times daily for 10 days

-         Adjunct

o       Nasal spray decongestant

§         Phenylephrine hydrochloride

§         Oxymetazoline hydrochloride

·        May facilitate drainage

·        No more than 72 hours because possible rebound congestion

o       Oral decongestant

o       Pseudoephedrine and phenylpropanolamine

§         Reduce nasal blood flow through their alpha adrenergic activity

o       Antihistamines

§         Not effective, because causes dryness of mucosal membrance

 

 
 
 

 

 

 
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