Mainz et al listed findings associated with more serious cases of bacterial sinusitis. These can help to identify a patient who may benefit from more aggressive management. The authors are from Jena University Hospital in Germany.
Patient selection: bacterial sinusitis
Warning symptoms requiring immediate referral:
(1) periorbital edema and/or erythema
(2) displaced globe
(3) double vision
(4) ophthalmoplegia
(5) reduced visual acuity
(6) severe unilateral or bilateral frontal headache
(7) frontal swelling
(8) signs of meningitis (reduced level of consciousness, neurological signs, etc)
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