Lindback et al identified clinical and laboratory findings associated with acute bacterial sinusitis. This can help identify patients who may benefit from additional diagnostic tests.
Sinus CT was used as the gold standard for diagnosis. CT findings used to diagnose acute sinusitis included:
(1) presence of an air-fluid level
(2) opacification of any sinus
Findings associated with acute bacterial sinusitis on logistic regression analysis:
(1) purulent secretion in the cavum nasi
(2) purulent rhinorrhea
(3) "double sickening" (two phases of illness, with an initial viral or allergic rhinitis followed by the onset of the bacterial sinusitis)
(4) ESR > 10 mm in first hour
Parameter
Finding
Points
purulent secretions at cavum nasi
absent
0
present
1
purulent rhinorrhea
absent
0
present
1
double sickening
absent
0
present
1
ESR
<= 10 mm in first hour
0
> 10 mm
1
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 4
• A score >= 3 was associated with acute bacterial sinusitis.
Performance:
• The cutoff of >= 3 had a sensitivity of 66% and specificity of 81%.
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