Sinusitis (Rhinosinusitis)--Subacute/Chronic

Paul G. Auwaerter, M.D., Andrew Victores, M.D.
Sinusitis (Rhinosinusitis)--Subacute/Chronic is a topic covered in the Johns Hopkins ABX Guide.

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PATHOGENS

  • Bacteriology of chronic sinusitis less well defined than acute sinusitis [that is typically caused by Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis].
    • A multifactorial disease that aside from infection is thought to result from genetics, environmental or occupational exposures, allergy, immunodeficiencies.
    • Acute exacerbations of chronic sinusitis may be caused by typical respiratory pathogens noted above.
  • Polymicrobial flora typically found if sinuses are cultured
  • Controversy exists over the role of fungi in chronic sinusitis.
    • The suggestion that fungal elements may be inciting an eosinophil-mediated immune response in sinonasal mucosa.

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Last updated: September 5, 2019