Travel Reference
In-Depth Information
Figure 16-1. Location of the frontal and maxillary sinuses
Fever rarely gets higher than 102°F (39°C) and may be entirely absent. Tenderness
may be present over the involved sinus. Infection in the maxillary sinuses may produce
pain or tenderness in the teeth of the upper jaw.
The treatment of acute sinusitis consists of drainage and antibiotic therapy. (Treatment
of chronic sinusitis should be directed by a physician.) A decongestant nasal spray should
be administered at regular intervals to reduce the swelling of the nasal mucosa and permit
drainage through the canals that enter the sinuses. Spraying should be repeated ten minutes
after the first application to make sure the spray reaches the recesses where the openings
of these canals are located. (Because rebound swelling of the mucosa occurs when the de-
congestant spray wears off, some physicians recommend a twelve-hour spray that is only
administered at night.) A systemic decongestant also can be administered. In a remote
area, amoxicillin/clavulanate (Augmentin®) should be given for ten days. Trimethoprim-
sulfamethoxazole (TMP-SMX, brand names Bactrim or Septra®) is a substitute for indi-
viduals allergic to penicillin.
Acute sinusitis usually clears up within a few days. Symptoms persisting for more than
seven to ten days may be indicative of a complication and should prompt serious consider-
ationofevacuation.Ifanindividualappearsveryillandswellingispresentaroundtheeyes
ornose,whichisasignofspreadoftheinfection,promptevacuationshouldbeconsidered.
Middle ear infections sometimes accompany or follow acute sinusitis (see “
Ear Infec-
tions
”).
Nosebleed
Nosebleediscommonlyaresultoftrauma,butmanynosebleedsdonotfollowaninjury.
Regardless of the cause, the treatment is similar. (Care for this problem is discussed in
SORE THROAT (PHARYNGITIS)
Sore throat is a common symptom that is produced by a number of different conditions.
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