Select a Community
Are you sure you want to trigger topic in your Anconeus AI algorithm?
You are done for today with this topic.
Would you like to start learning session with this topic items scheduled for future?
Amoxicillin-clavulanate
42%
8/19
Amphotericin and debridement
11%
2/19
CT head
16%
3/19
MRI head
0%
0/19
Pseudoephedrine and follow up in 1 week
32%
6/19
Select Answer to see Preferred Response
This patient is presenting with sinus pressure and drainage which is concerning for viral or bacterial sinusitis. In a healthy patient with mild symptoms, observation and symptomatic treatment (pseudoephedrine) with follow up in 1 week is appropriate. Acute rhinosinusitis can present with pressure over the sinuses and nasal discharge. It can be caused by bacterial or viral etiologies, of which viral is more common. In healthy patients, most cases of sinusitis will resolve on their own, thus the only treatment needed is symptomatic treatment such as decongestants and possibly pain medications (such as NSAIDs). Persistent sinusitis, sinusitis with severe symptoms and a high fever, or critically ill patients may require antibiotic treatment at the onset of symptoms. Incorrect Answers: Answer 1: Amoxicillin-clavulanate is an appropriate and preferred initial antibiotic in the management of sinusitis if this patient's symptoms did not improve after 1 week of symptomatic treatment. Answer 2: Amphotericin and debridement is appropriate management of a mucor or rhizopus infection which presents with a necrotic and infected lesion in the nasal region which is commonly seen in immunocompromised patients (in particular type I diabetics and during diabetic ketoacidosis). It is a rapidly progressive and fatal disease which requires debridement and amphotericin. Answers 3-4: CT head and MRI head or any imaging is not routinely indicated for sinusitis. However, if the patient had a fever, severe pain, worsening symptoms, or ear canal drainage in the setting of appropriate risk factors (such as poorly managed diabetes or HIV) imaging may be indicated for osteomyelitis/malignant otitis externa. Bullet Summary: Acute sinusitis in a healthy patient with mild symptoms can initially be managed with observation and symptomatic treatment only.
4.1
(7)
Please Login to add comment