3
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 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 acute rhinosinusitis are present less than
10 days, and
b. The symptoms are not worsening.
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 acute rhinosinusitis fail to improve within 10
days or more beyond the onset of upper respiratory symptoms, or
b. Symptoms or signs of acute rhinosinusitis 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, or
• 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 and/or
• Radiographic imaging showing inflammation of the paranasal sinuses.
Recurrent
acute
rhinosinusitis
(RARS)
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.
