Signs of sinusitis

So what's it take to get an antibiotic prescription these days? It's not just the arbitrary whim of a doctor too harried to argue nor a pharmocological sympathy vote for the best hard luck story of the day. I'd like to banish your bug before your long-planned trip to Ireland too, but there is a bit of science to discerning that which responds to antibiotics and a lot to lose if these medications are too freely prescribed.

Researchers at the University of Oslo set out to answer that age-old riddle, how do you tell a Norwegian with bacterial sinusitis from one with just a cold? They identified four clinical factors that separated CT scan proven sinusitis (as in responds to antibiotics) from the great viral pretenders: 1) A history of purulent--as in nasty, colored--drainage from the nose, 2) tooth pain, 3) seeing that yucko stuff in the nose on exam, and 4) an elevation of a blood test called the erythrocyte sedimentation rate which is an indication of inflammation and infection. Sickly Norwegians with three out of four of these miserable signs had an 86% chance of having sinusitis, and the diagnosis could be made quickly and without costly imaging studies.

An additonal important clue noted by Dr. Morten Lindbaek was a history of a two-phase illness that's lasted at least 7 days. In other words, a patient begins with a common cold that abruptly gets worse and lasts longer than average, presumably due to a secondary bacterial sinus infection. Dr. Lindbaek found that the majority of patients with CT-confirmed sinusitis had symptoms for a week or more while those with shorter illnesses generally had clear-headed scans.