Acute sinusitis is a symptomatic inflammation of ≥1 paranasal sinuses of Viruses cause about 90-98% of cases. Incidence is highest in early fall through early spring (related to incidence of viral upper respiratory infection [URI]). Adults have two to three viral URIs per year; 90% of these colds are accompanied by viral rhinosinusitis. Important features - Headache, Nasal congestion, Eye pain, Ear Pain, Chronic cough - Inflammation, obstruction, and edema of the sinuses, followed by impaired clearance and damage to the mucous sinus surfaces. Secretions that are not cleared become hospitable to bacterial growth. When to be concerned about bacterial and treat with antibiotics (0.5-2% of viral cases): - More likely if symptoms worsen within 5 to 6 days after initial improvement - No improvement within 10 days of symptom onset - 3 to 4 days of fever 102°F and facial pain and purulent nasal discharge My Reccomendations: - Avoid smoking and exposure to second hand smoke. - Antihistamine like Benadryl - Albuterol or an alternative you can tolerate - Frequent Hand-washing - Steam inhalation (warm shower) 20 to 30 minutes three times daily - Hydration - Saline irrigation (Neti pot) or nose drops - Sleep with head of bed elevated. - Avoid caffeine and alcohol. - Analgesics, NSAIDs (tylenol, Aspirin, Ibuprofen) *Antibiotics are indicated only when findings suggest bacterial infection. -Symptoms requiring urgent attention: Visual disturbances, Eye swelling or Redness, Altered mental status