Hadley J A
Genesee Valley Otolaryngology, LLC, Rochester, NY 14618, USA.
Postgrad Med. 2000 Dec;108(7 Suppl Contemporaty):30-6. doi: 10.3810/pgm.12.2000.suppl10.54.
Rhinosinusitis is a common inflammatory bacterial infection of the paranasal sinuses and nasal cavity. Viral infection is often the inciting event. The ensuing inflammation obstructs the narrow ostiomeatal complex, causing facial pain and pressure, nasal obstruction, congestion, postnasal drainage, and mucopurulence. The exacerbation of symptoms after 5 to 7 days or their persistence for more than 10 days indicates acute rhinosinusitis. Acute infection lasts less than 4 weeks and resolves completely with therapy. Chronic rhinosinusitis is defined as the persistence of symptoms beyond 12 weeks. Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pneumoniae are the primary respiratory tract pathogens involved in both acute and chronic rhinosinusitis. Management is aimed at controlling the infection and decreasing inflammation. The emergence of bacterial resistance can be avoided by the appropriate use of antibiotics. Antibiotic selection is usually empirical, except when culture is possible, and is directed by the common pathogens and their resistance patterns in a given community. Adjunctive therapies can be beneficial in relieving symptoms.
鼻窦炎是鼻窦和鼻腔常见的细菌性炎症感染。病毒感染通常是诱发因素。随之而来的炎症会阻塞狭窄的窦口鼻道复合体，导致面部疼痛和压痛、鼻塞、充血、鼻后滴漏以及黏液脓性分泌物。症状在5至7天后加重或持续超过10天表明为急性鼻窦炎。急性感染持续时间少于4周，经治疗可完全缓解。慢性鼻窦炎定义为症状持续超过12周。流感嗜血杆菌、卡他莫拉菌和肺炎链球菌是急性和慢性鼻窦炎中主要涉及的呼吸道病原体。治疗旨在控制感染和减轻炎症。通过合理使用抗生素可避免细菌耐药性的出现。抗生素的选择通常是经验性的，除非能够进行培养，且选择依据特定社区中的常见病原体及其耐药模式。辅助治疗有助于缓解症状。
