Table 1. Rhinosinusitis Definitions
Term Definition
Acute
rhinosinusitis
(ARS)
Up to 4 weeks of purulent nasal drainage (anterior, posterior, or
both) accompanied by nasal obstruction, facial pain-pressure-fullness
or both:
a
Purulent nasal discharge is cloudy or colored, in contrast to the
clear secretions that typically accompany viral upper respiratory
infection, and may be reported by the patient or observed on
physical examination.
Nasal obstruction may be reported by the patient as nasal
obstruction, congestion, blockage, or stuffiness, or may be
diagnosed by physical examination.
Facial pain-pressure-fullness may involve the anterior face,
periorbital region, or manifest with headache that is localized or
diffuse.
Viral
rhinosinusitis
(VRS)
Acute rhinosinusitis that is caused by, or is presumed to be caused by,
viral infection. A clinician should diagnose VRS when:
a. symptoms or signs of ARS are present for less than 10 days and the
symptoms are not worsening.
Acute bacterial
rhinosinusitis
(ABRS)
Acute rhinosinusitis that is caused by, or is presumed to be caused by,
bacterial infection. A clinician should diagnose ABRS when:
a. symptoms or signs of ARS fail to improve within 10 days or more
beyond the onset of upper respiratory symptoms, or
b. symptoms or signs of ARS worsen within 10 days after an initial
improvement (double worsening ).
Chronic
rhinosinusitis
(CRS)
Twelve weeks or longer of two or more of the following signs and
symptoms:
• mucopurulent drainage (anterior, posterior, or both)
• nasal obstruction (congestion)
• facial pain-pressure-fullness
• decreased sense of smell
AND inflammation is documented by one or more of the following
findings:
• purulent (not clear) mucus or edema in the middle meatus or
anterior ethmoid region
• polyps in nasal cavity or the middle meatus
• radiographic imaging showing inflammation of the paranasal
sinuses.
Recurrent acute
rhinosinusitis
(ABRS)
Four or more episodes per year of ABRS without signs or symptoms
of rhinosinusitis between episodes:
• each episode of ABRS should meet diagnostic criteria above.
a
Facial pain-pressure-fullness in the absence of purulent nasal discharge is insufficient to
establish a diagnosis of ARS.
