Twenty-four adults with clinical evidence of sinusitis were studied by 65 needle punctures of the maxillary antrum. Fourteen of 15 sinuses with normal transillumination and 19 of 26 that were dull had normal aspirates, whereas 24 of 24 that were opaque had abnormal aspirates (P less than 0.001). Marked mucosal thickening as determined radiologically (Water's view) was associated with abnormal aspirates whereas lesser mucosal thickening was not (P less than 0.001). In acute sinusitis, there was a strong correlation between high aspirate leukocyte counts (greater than 1000 per cubic millimeter) and infection as manifested by bacterial titers of greater than 10(5) per milliliter or the isolation of virus fungus (P greater than 0.001). Anterior-nasal-swab cultures correlated poorly with direct aspirate culters. Organisms frequently recovered from the sinus included Haemophilus influenzae, Strepto coccus pneumoniae, and anaerobic bacteria. Rhinovirus was recovered twice. Antibiotics were usedful in patients with acute sinusitis if the organism was sensitive in vitro (P less than 0.001).
This article has been cited by other articles:
Hwang, P. H.
(2009). A 51-Year-Old Woman With Acute Onset of Facial Pressure, Rhinorrhea, and Tooth Pain: Review of Acute Rhinosinusitis. JAMA
301: 1798-1807
[Abstract][Full Text]
Peltola, V. T., Boyd, K. L., McAuley, J. L., Rehg, J. E., McCullers, J. A.
(2006). Bacterial Sinusitis and Otitis Media following Influenza Virus Infection in Ferrets.. Infect. Immun.
74: 2562-2567
[Abstract][Full Text]
Pratter, M. R.
(2006). Chronic Upper Airway Cough Syndrome Secondary to Rhinosinus Diseases (Previously Referred to as Postnasal Drip Syndrome): ACCP Evidence-Based Clinical Practice Guidelines. Chest
129: 63S-71S
[Abstract][Full Text]
Alymova, I. V., Portner, A., Takimoto, T., Boyd, K. L., Babu, Y. S., McCullers, J. A.
(2005). The Novel Parainfluenza Virus Hemagglutinin-Neuraminidase Inhibitor BCX 2798 Prevents Lethal Synergism between a Paramyxovirus and Streptococcus pneumoniae. Antimicrob. Agents Chemother.
49: 398-405
[Abstract][Full Text]
Piccirillo, J. F.
(2004). Acute Bacterial Sinusitis. NEJM
351: 902-910
[Full Text]
Subcommittee on Management of Sinusitis and Commit,
(2001). Clinical Practice Guideline: Management of Sinusitis. Pediatrics
108: 798-808
[Abstract][Full Text]
Hickner, J. M., Bartlett, J. G., Besser, R. E., Gonzales, R., Hoffman, J. R., Sande, M. A.
(2001). Principles of Appropriate Antibiotic Use for Acute Rhinosinusitis in Adults: Background. ANN INTERN MED
134: 498-505
[Abstract][Full Text]
Puhakka, T., Heikkinen, T., Makela, M. J., Alanen, A., Kallio, T., Korsoff, L., Suonpaa, J., Ruuskanen, O.
(2000). Validity of Ultrasonography in Diagnosis of Acute Maxillary Sinusitis. Arch Otolaryngol Head Neck Surg
126: 1482-1486
[Abstract][Full Text]
Yoon, H. J., Zhu, Z., Gwaltney, J. M. Jr., Elias, J. A.
(1999). Rhinovirus Regulation of IL-1 Receptor Antagonist In Vivo and In Vitro: A Potential Mechanism of Symptom Resolution. J. Immunol.
162: 7461-7469
[Abstract][Full Text]
Bomer, K., Brichta, A., Baroody, F., Boonlayangoor, S., Li, X., Naclerio, R. M.
(1998). A Mouse Model of Acute Bacterial Rhinosinusitis. Arch Otolaryngol Head Neck Surg
124: 1227-1232
[Abstract][Full Text]
de Ferranti, S. D, Ioannidis, J. P A, Lau, J., Anninger, W. V, Barza, M.
(1998). Are amoxycillin and folate inhibitors as effective as other antibiotics for acute sinusitis? A meta-analysis. BMJ
317: 632-637
[Abstract][Full Text]
Yang, Y.-p., Thomas, W. R., Chong, P., Loosmore, S. M., Klein, M. H.
(1998). A 20-Kilodalton N-Terminal Fragment of the D15 Protein Contains a Protective Epitope(s) against Haemophilus influenzae Type a and Type b. Infect. Immun.
66: 3349-3354
[Abstract][Full Text]
Brook, I.
(1998). Microbiology of Nosocomial Sinusitis in Mechanically Ventilated Children. Arch Otolaryngol Head Neck Surg
124: 35-38
[Abstract][Full Text]
Slavin, R. G.
(1997). Nasal Polyps and Sinusitis. JAMA
278: 1849-1854
[Abstract]
Zhu, Z., Tang, W., Gwaltney, J. M. Jr., Wu, Y., Elias, J. A.
(1997). Rhinovirus stimulation of interleukin-8 in vivo and in vitro: role of NF-kappa B. Am. J. Physiol. Lung Cell. Mol. Physiol.
273: L814-L824
[Abstract][Full Text]
Nicholson, K. G, Kent, J., Hammersley, V., Cancio, E.
(1996). Risk factors for lower respiratory complications of rhinovirus infections in elderly people living in the community: prospective cohort study. BMJ
313: 1119-1123
[Abstract][Full Text]
Brook, I., Yocum, P., Frazier, E. H., Bartlett, J. G.
(1996). Bacteriology and {beta}-Lactamase Activity in Acute and Chronic Maxillary Sinusitis. Arch Otolaryngol Head Neck Surg
122: 418-423
[Abstract]
Williams, J. W. Jr, Holleman, D. R. Jr, Samsa, G. P., Simel, D. L.
(1995). Randomized Controlled Trial of 3 vs 10 Days of Trimethoprim/Sulfamethoxazole for Acute Maxillary Sinusitis. JAMA
273: 1015-1021
[Abstract]
Holleman, D. R. Jr, Williams, J. W. Jr, Simel, D. L.
(1995). Usual Care and Outcomes in Patients With Sinus Complaints and Normal Results of Sinus Roentgenography. Arch Fam Med
4: 246-251
[Abstract]
Fuller, C. G., Schoettler, J. J., Gilsanz, V., Nelson, M. D. JR, Church, J. A., Richards, W.
(1994). Sinusitis in Status Asthmaticus. CLIN PEDIATR
33: 712-719
[Abstract]
Brook, I., Thompson, D. H., Frazier, E. H.
(1994). Microbiology and Management of Chronic Maxillary Sinusitis. Arch Otolaryngol Head Neck Surg
120: 1317-1320
[Abstract]
Evans, K. L
(1994). Fortnightly Review: Diagnosis and management of sinusitis. BMJ
309: 1415-1422
[Full Text]
Paker, G. E., Graham, J. A., Rauch, A. M., Collins, J. J.
(1994). Cefuroxime Axetil in the Treatment of Sinusitis: A Review. Arch Fam Med
3: 165-175
[Abstract]
Gwaltney, J. M., Phillips, C. D., Miller, R. D., Riker, D. K.
(1994). Computed Tomographic Study of the Common Cold. NEJM
330: 25-30
[Abstract][Full Text]
Williams, J. W. Jr, Simel, D. L.
(1993). Does This Patient Have Sinusitis? Diagnosing Acute Sinusitis by History and Physical Examination. JAMA
270: 1242-1246
[Abstract]
Calenoff, E., McMahan, J. T., Herzon, G. D., Kern, R. C., Ghadge, G. D., Hanson, D. G.
(1993). Bacterial Allergy in Nasal Polyposis A New Method for Quantifying Specific IgE. Arch Otolaryngol Head Neck Surg
119: 830-836
[Abstract]
Williams, J. W. Jr., Simel, D. L.
(1993). Diagnosing Sinusitis. ANN INTERN MED
119: 92-92
[Full Text]
Huck, W., Reed, B. D., Nielsen, R. W., Ferguson, R. T., Gray, D. W., Lund, G. K., ZoBell, D. H., Moster, M. B.
(1993). Cefaclor vs Amoxicillin in the Treatment of Acute, Recurrent, and Chronic Sinusitis. Arch Fam Med
2: 497-503
[Abstract]
Williams, J. W. Jr, Simel, D. L., Roberts, L., Samsa, G. P.
(1992). Clinical Evaluation for Sinusitis: Making the Diagnosis by History and Physical Examination. ANN INTERN MED
117: 705-710
[Abstract]
Jacobs, T. E., Irwin, R. S., Raptopoulos, V.
(1990). Upper Respiratory Tract Infections in the Critically I11. J Intensive Care Med
5: 129-152
[Abstract]
Sydnor, A. Jr, Gwaltney, J. M. Jr, Cocchetto, D. M., Scheld, W. M.
(1989). Comparative Evaluation of Cefuroxime Axetil and Cefaclor for Treatment of Acute Bacterial Maxillary Sinusitis. Arch Otolaryngol Head Neck Surg
115: 1430-1433
[Abstract]
Linden, B. E., Aguilar, E. A., Allen, S. J.
(1988). Sinusitis in the Nasotracheally Intubated Patient. Arch Otolaryngol Head Neck Surg
114: 860-861
[Abstract]
Harris, G. J.
(1988). Subperiosteal Inflammation of the Orbit: A Bacteriological Analysis of 17 Cases. Arch Ophthalmol
106: 947-952
[Abstract]
Schwartz, H. J., Thompson, J. S., Sher, T. H., Ross, R. J.
(1987). Occult Sinus Abnormalities in the Asthmatic Patient. Arch Intern Med
147: 2194-2196
[Abstract]
Dans, P. E.
(1986). The Management of Sore Throat: Adjusting to Success. JAMA
256: 3392-3393
[Abstract]
Caplan, E. S., Hoyt, N. J.
(1982). Nosocomial Sinusitis. JAMA
247: 639-641
[Abstract]
Brook, I.
(1981). Bacteriologic Features of Chronic Sinusitis in Children. JAMA
246: 967-969
[Abstract]
NEU, H. C.
(1979). Amoxicillin. ANN INTERN MED
90: 356-360
[Abstract]
Dudley, J. P., Goldstein, E. J. C., George, W. L., Bock, B. V., Kirby, B. D., Finegold, S. M.
(1978). Sinus Infection Due to Eikenella corrodens. Arch Otolaryngol Head Neck Surg
104: 462-463
[Abstract]