acute

Last edited 09/2018

Aute rhinosinusitis (ARS) is a common condition seen in primary care clinics

  • prevalence rate in studies specifying ARS is between 6-12%
    • prevalence varies with season (higher in the winter months) and climatic variations, and increasing with a damp environment and air pollution.
  • it has been estimated that adults suffer two to five episodes of viral ARS (or colds) per year and school children may suffer seven to ten colds per year

The European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS) defines acute rhinosinusitis as

  • in adults - sudden onset of two or more symptoms, one of which should be either nasal blockage/obstruction/congestion or nasal discharge (anterior/posterior nasal drip):
    • ± facial pain/pressure,
    • ± reduction or loss of smell

    for <12 weeks

  • in children - 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 (1)

ARS could be divided theoretically into viral (common cold), post-viral and bacterial ARS (ABRS) and they usually appear in this consecutive order (1).
Most ARS begins when a viral upper respiratory infection (URI) extends into the paranasal sinuses, which may be followed by bacterial infection (2)

  • approximately 0.5-2% of viral upper respiratory tract infections are complicated by bacteria infection (1)

Note:

  • ARS can be considered as recurrent but only if the previous episode has fully resolved

Reference:

  1. Fokkens WJ et al.European Position Paper on Rhinosinusitis and Nasal Polyps 2012. Rhinol Suppl. 2012;23:3 p   
  2. Rosenfeld RM et al. Clinical practice guideline (update): adult sinusitis. Otolaryngol Head Neck Surg. 2015;152(2 Suppl):S1-S39