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Rhinosinusitis

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Diagnosis Table 1. Conventional Criteria for the Diagnosis of Sinusitis Based on the Presence of at Least 2 "Major" or 1 "Major" and 2 or More "Minor" Symptoms Major Symptoms > Purulent anterior nasal discharge > Purulent or discolored posterior nasal discharge > Nasal congestion or obstruction > Facial congestion or fullness > Facial pain or pressure > Hyposmia or anosmia > Fever (for acute sinusitis only) Minor Symptoms > Headache > Ear pain, pressure or fullness > Halitosis > Dental pain > Cough > Fever (for subacute or chronic sinusitis) > Fatigue Table 2. Prevalence (Mean Percent of Positive Specimens) of Various Respiratory Pathogens From Sinus Aspirates in Patients with ABRS Publications Before 2000 Microbial Agent Streptococcus pneumoniae Haemophilus influenzae Moraxella catarrhalis Streptococcus pyogenes Staphylococcus aureus Gram-negative bacilli (includes Enterobacteriaceae spp) Anaerobes (Bacteroides, Fusobacterium, Peptostreptococcus)a Respiratory viruses No growth a Primarily in odontogenic infections. Adults (%) 30-43 31-35 2-10 2-7 2-3 0-24 0-12 3-15 40-50 Children (%) 44 30 30 2 - 2 2 - 30 Publications in 2010 Adults (%) 38 36 16 4 13 - - - 36 Children (%) 21-33 31-32 8-11 - 1 - - - 29

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