| Prospective Observational Study of Chronic Rhinosinusitis: Environmental Triggers and Antibiotic Implications. | |
| | |
MedLine Citation:
|
PMID: 22114094 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
|
Background. A prolonged course of antibiotic therapy is often initiated for chronic rhinosinusitis (CRS) based on symptomatology. We examined differences in clinical manifestations and underlying conditions in patients with symptoms typical for CRS. CT scan abnormality of the sinuses was the gold standard for diagnosis of CRS.Methods. We performed a prospective observational study of 125 adults with classic symptoms of CRS undergoing nasal endoscopy and sinus CT.Results. The patients were classified into 2 groups: (1) those with radiographic evidence of sinusitis by CT (Sx + CT) (75) and (2) those with normal CT scans of the sinus (Sx - CT) (50). Decreased smell was significantly more common in Sx + CT than in Sx - CT patients, (P = .003). Paradoxically, headache, facial pain, and sleep disturbance occurred significantly more frequently in patients with Sx - CT than in patients with Sx + CT (P < .05). The absence of mucopurulence on endoscopy proved to be highly specific for Sx - CT patients (100%). On the other hand, sensitivity was low; only 24% of Sx + CT patients demonstrated mucopurulence by endoscopy. Improvement in response to antibiotics was similar between both CRS categories.Conclusions. Most symptoms considered to be typical for CRS proved to be nonspecific. Interestingly, symptoms that were more severe were significantly more likely to occur in younger patients who were Sx - CT. The efficacy of antibiotic therapy was uncertain. We suggest that objective evidence of mucopurulence assessed by endoscopy or CT should be obtained if antibiotics are to be given for prolonged duration. We recommend a moratorium for the widespread practice of a prolonged course of empiric antibiotics in patients with presumed CRS. |
| | |
Authors:
|
Berrylin J Ferguson; Masashi Narita; Victor L Yu; Marilyn M Wagener; Jack M Gwaltney |
Related Documents
:
|
19353344 - Three-dimensional double-echo steady-state (3d-dess) magnetic resonance imaging of the ... 12707584 - Radiographic tools for assessment of pathologic cartilage calcification. 2281774 - Magnetic resonance knee arthrography. enhanced contrast by gadolinium complex in the ra... 15501404 - The structural adaptations in compressed articular cartilage by microscopic mri (microm... 21360744 - Assessment of radiofrequency self-heating around a metallic wire with mr t1-based therm... 17138074 - Cerebellar abscess and syringomyelia due to isoniazid-resistant mycobacterium tuberculo... |
Publication Detail:
|
Type: JOURNAL ARTICLE Date: 2011-11-22 |
Journal Detail:
|
Title: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America Volume: - ISSN: 1537-6591 ISO Abbreviation: - Publication Date: 2011 Nov |
Date Detail:
|
Created Date: 2011-11-24 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 9203213 Medline TA: Clin Infect Dis Country: - |
Other Details:
|
Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
|
Department of Otolaryngology, and. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Hepatitis B prevention, diagnosis, treatment and care: a review.
Next Document: Antagonistic interaction of BLADE-ON-PETIOLE1 and 2 with BREVIPEDICELLUS and PENNYWISE regulates Ara...