Acute Bacterial Rhinosinusitis and Secondary Acute Laryngitis Diagnosis and Management

Diagnostic Criteria

The Infectious Diseases Society of America (IDSA) criteria for acute bacterial rhinosinusitis (ABRS) include symptoms persisting >10 days without improvement, which is met by this patient's 18-day illness course 1, 2
The American Academy of Otolaryngology-Head and Neck Surgery recommends considering unilateral sinus congestion and pressure as a diagnostic criterion for ABRS 3, 4
The absence of fever does not exclude bacterial infection, as many ABRS cases are afebrile, according to the American Academy of Pediatrics 5, 4, 1

The American College of Physicians recommends first-line antibiotic therapy with amoxicillin-clavulanate 875-125mg twice daily for 5-7 days for ABRS 1
The IDSA guidelines recommend continuing intranasal corticosteroids, such as Flonase, for reducing inflammation in ABRS patients 3, 1
The American Academy of Otolaryngology-Head and Neck Surgery suggests continuing nasal saline irrigation as an adjunctive therapy for ABRS 1

The American Academy of Otolaryngology-Head and Neck Surgery recommends voice rest, adequate hydration, and humidified air to reduce laryngeal irritation and promote healing 2

The American Academy of Pediatrics states that viral URIs are most contagious in the first 2-3 days of symptoms, and by day 18, viral shedding has essentially ceased 5, 2
The Infectious Diseases Society of America notes that bacterial sinusitis is generally not considered contagious person-to-person 4

The American Academy of Pediatrics advises against relying on the absence of fever to exclude bacterial infection, as many ABRS cases are afebrile 5, 4, 1
The American College of Physicians warns against relying on nasal discharge color as a reliable indicator of bacterial vs viral infection 3, 1, 2