Acute rhinosinusitis in children is defined as sudden onset of two or more of the symptoms:
• nasal blockage/obstruction/congestion
• or discoloured nasal discharge
• or cough (daytime and night-time)
for < 12 weeks; with symptom free intervals if the problem is recurrent.
Assessment should also be made of allergic symptoms (i.e. sneezing, watery rhinorrhoea, nasal itching, and itchy watery eyes). ARS can occur once or more than once in a defined time period. This is usually expressed as episodes/year but there must be complete resolution of symptoms between episodes for it to constitute genuine recurrent ARS.
ARS – Clinical Course:
- Common cold/ acute viral rhinosinusits is defined as: duration of symptoms for less than 10 days.
- Acute post-viral rhinosinusitis is defined as: increase of symptoms after 5 days or persistent symptoms after 10 days with less than 12 weeks duration.
- Acute bacterial rhinosinusitis (ABRS) is suggested by the presence of at least 3 symptoms/signs of:
- Discoloured discharge (with unilateral predominance) and purulent secretion in the nasal cavity
- Severe local pain (with unilateral predominance)
- Fever (>38ºC)
- Elevated ESR/CRP
- ‘Double sickening’ (i.e. a deterioration after an initial milder phase of illness).
Please see Primary Care management for further detail.
