Rhinosinusitis in children, as in adults, can be classified by duration (acute, recurrent, and chronic) and by cause (viral, bacterial, and inflammatory) and needs to be treated accordingly after careful investigation which include through clinical history, laboratory tests, and, if necessary, nasal endoscopy and imaging studies.
Key points
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Acute rhinosinusitis (ARS) is defined as upper respiratory infection symptoms increasing after 5 days or persisting after 10 days.
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Among patients with ARS, signs of potential acute bacterial rhinosinusitis include at least 3 of the 5 criteria: fever, discolored mucus, worsening symptoms, Table 1 severe pain, and raised ESR/CRP.
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Chronic rhinosinusitis (CRS) in children is defined as presence of 2 or more symptoms, one of which should be either nasal obstruction or nasal discharge), plus facial pressure or cough, for more than or equal to 12 weeks.
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Pathology of CRS is not completely understood, and treatment includes nasal irrigation, nasal and oral steroid, and remedial approaches for allergy and immune defect.
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The most common immune deficiency in CRS is the low levels of pneumococcal antibodies, which must be corrected by vaccination.
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