Sinusitis (Rhinosinusitis)--Subacute/Chronic

Paul G. Auwaerter, M.D., Andrew Victores, M.D.


  • The bacteriology of chronic sinusitis is less well-defined than acute sinusitis (typically due to Streptococcus pneumonia, Haemophilus influenzae, and Moraxella catarrhalis).
    • A multifactorial disease that, aside from infection, is thought to result from genetics, environmental or occupational exposures, allergies, and immunodeficiencies.
    • Typical respiratory pathogens may cause acute exacerbations of chronic sinusitis noted above.
  • Polymicrobial flora is typically found if sinuses are cultured, especially in patients with a history of sinus surgeries, but the role of recovered organisms is often unclear.
  • Controversy exists over the role of fungi in chronic sinusitis.
    • The suggestion is that fungal elements may incite an eosinophil-mediated immune response in sinonasal mucosa.

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Last updated: April 15, 2023