What duration of respiratory tract infection suggests acute sinusitis (sinus infection)?

Updated: Mar 01, 2018
  • Author: Itzhak Brook, MD, MSc; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

The duration of the condition should be determined. Suspect acute sinusitis in any patient with an upper respiratory tract infection that persists beyond 7-10 days, particularly if the infection is severe and is accompanied by high fever, purulent nasal discharge, or periorbital edema (ethmoid sinusitis).

The condition may start as an upper respiratory tract infection, and the patient may seem to be recovering; however, the condition becomes acutely worse around the seventh day of illness. This should be considered a red flag because most upper respiratory tract infections last 5-7 days. The natural history of rhinovirus infection, as described by Gwaltney et al, lasts from 1-33 days. One fourth of patients have symptoms that last longer than 14 days. [28]


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