Diagnostic accuracy of history and physical examination in bacterial acute rhinosinusitis

Abstract

We found symptoms or their change to be of little use in identifying bacterial ARS. In contrast, we observed several clinical findings after 9 to 10 days of symptoms to predict bacterial ARS quite accurately.

Imaging follow-up study of acute rhinosinusitis

“…Background information was collected at enrolment, and a viral polymerase chain reaction was taken from the nasopharynx as described previously . The presence of nasal symptoms was recorded in symptom diaries . The patients recorded facial pain/pressure, nasal blockage, clear nasal discharge, purulent nasal discharge, postnasal discharge, and reduction/loss of smell and graded their severity as 0 (no) to 10 (worst possible).…”

“…9 The presence of nasal symptoms was recorded in symptom diaries. 10 The patients recorded facial pain/pressure, nasal blockage, clear nasal discharge, purulent nasal discharge, postnasal discharge, and reduction/loss of smell and graded their severity as 0 (no) to 10 (worst possible). We added up the grades for each symptom to get a total nasal symptom score (0-60) for each day during the ARS episode.…”

Longitudinal analysis of inflammatory biomarkers during acute rhinosinusitis

“…We have earlier examined the respective figures for various symptoms and clinical findings in this same material. 20 Compared to these diagnostic measures, the finding of elevated CRP ( 11 mg/L) proved to be better at predicting bacterial ARS than symptoms; it paralleled the findings of moderate or profuse amount of nasal secretion and cervical adenopathy but was poorer than the finding of nasal secretion in the posterior pharynx (supplementary material). Moderately elevated CRP ( 49 mg/L) accurately predicted bacterial ARS but only was present in four patients.…”

“…We summed up the grades for each symptom to obtain a total symptom score (0-60) for each day. 9,20 Cone-Beam Computed Tomography of the Paranasal Sinuses. A paranasal cone-beam computed tomography (CBCT) scan was taken at enrollment and at the follow-up visit.…”

“…The recorded symptoms, imaging examinations, and microbiologic specimen and analyses have been described earlier in detail. 9,20,21 What follows is a brief description of these data.…”