Tuesday, November 07, 2006

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.

1 comment:

sharon said...

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Sinusitis is an inflammation of the mucus membranes or lining of the Para nasal sinuses. Acute sinusitis is common and is often associated with a viral or bacterial nasal infection that spreads to the sinuses. When the sinuses become blocked, they become filled with fluid producing pain and pressure. Other symptoms of sinusitis are fever, fatigue, and postnasal drainage.