Paranasal sinusitis can occur as a nosocomial infection for a patient in the intensive care unit (ICU).

Risk factors:

(1) history of sinusitis

(2) nasopharyngeal tube (feeding, aspiration, intubation)

(3) orotracheal intubation

(4) longer duration of intubation and ventilation

(5) smoke inhalation

(6) immunosuppression


Early diagnosis is important, and this requires folow-up on clinical suspicion. A patient who is comatose or heavily sedated cannot complain of pain or pressure.


Diagnostic strategy:

(1) imaging studies of all paranasal sinuses

(2) aspiration of affected sinus showing neutrophils and bacterial or fungal pathogens



(1) remove nasopharyngeal tubing if possible

(2) decongestants

(3) antibiotics

(4) rarely surgical drainage

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