- Acute Sinusitis Evaluation
- Clinical Prediction Rule for Diagnosis of Acute Bacterial Rhinosinusitis
- Criteria
- Score 2: C-Reactive Protein >15 mg/dl
- Score 2: Maxillary Toothache
- Score 2: Purulent Nasal Drainage
- Score 2: Unilateral Tender Maxillary Sinus
- Score 1: Preceding respiratory tract infection
- Score -1: History of Rhinosinusitis
- Interpretation (total score -1 to 9)
- Total Score -1 to 3: Low Risk
- Likelihood of Acute Bacterial Rhinosinusitis: 16%
- Total Score 4 to 6: Moderate Risk
- Likelihood of Acute Bacterial Rhinosinusitis: 49%
- Total Score 7 to 8: High Risk
- Likelihood of Acute Bacterial Rhinosinusitis: 73%
- Total Score -1 to 3: Low Risk
- References
- Williams and Berg Prediction Rules
- Criteria
- Maxillary Toothache
- Purulent nasal secretion
- History of colored Nasal Discharge
- Poor response to nasal Decongestants
- Abnormal Sinus Transillumination
- Modifiers
- Symptoms >7-10 days increases diagnostic efficacy
- Interpretation: Berg Prediction Rule
- Positive if 2 or more criteria positive
- Efficacy if symptoms present >7-10 days
- Berg (1988) Acta Otolaryngol 105:343-9 [PubMed]
- Interpretation: Williams Prediction Rule
- Positive if 4 or more criteria present
- Intermediate if 2 or 3 criteria present
- Study recommended sinus radiography
- Negative if <2 criteria present
- References
- Task Force on Rhinosinusitis Prediction Rule
- Major Criteria
- Nasal obstruction or blockage
- Postnasal discharge or Rhinorrhea
- Hyposmia or Anosmia
- Major Criteria need accompanying other major criteria
- Facial pain, pressure, or fullness
- Fever (Acute Rhinosinusitis)
- Minor Criteria
- Interpretation: Positive for Acute Bacterial Sinusitis
- Two or more major criteria or
- One major criteria with two or more minor criteria or
- Nasal purulence seen on examination
- Reference