By vgreene, 12 September, 2016 If suspected orbital/intracranial extension, contrast CT sinuses/orbits +/- head (for intracranial study) (ACR7); contrast CT or contrast MRI recommended (AAI-JTF,8 AAP,9 IDSA10)
By vgreene, 12 September, 2016 Urgent attention if orbital swelling/pain, proptosis, severe HA, forehead/facial swelling, cranial nerve palsy, abnormal EOMs, visual disturbance/diplopia, photophobia, sz, focal neuro signs, systemic toxicity, altered mental status, meningeal signs, rapi
By vgreene, 12 September, 2016 If refractory/recurrent ABRS, consider referral to allergy/immunology, ID, or ENT (AAI-JTF,14 IDSA15); order noncontrast CT (ACR16). Evaluate recurrent ABRS for allergy, immune defect, CF, GERD, dysmotile cilia, obstructive anatomy (AAP17)
By vgreene, 12 September, 2016 Consider sx relief: nasal steroids (AAI-JTF,9 IDSA10); saline irrigations (IDSA11); IDSA recommends against antihistamines, decongestants.12 AAP makes no recommendation regarding sx relief tx13
By vgreene, 12 September, 2016 Start immediate abx6-8 or consider observation (AAP6) for pts w/ nonsevere persistent s/sx (not for severe or worsening pts)
By vgreene, 12 September, 2016 Acute Bacterial Rhinosinusitis Dx/Tx in Children | epocrates Guideline Synthesis
By vgreene, 12 September, 2016 Peer reviewed & based on multiple guidelines/recommendations from specialty societies/government agencies
