Diagnosis

Minor symptoms include clear nasal drainage, cough, etc.

Particularly in patients with a history of chronic perennial rhinosinusitis or during pollen activity in patients with seasonal allergies

Double sickening is the acute worsening of symptoms (fever ≥102ºF or facial pain/pressure or tenderness in addition to purulent nasal drainage for >3-4 days) after initial improvement from a viral upper respiratory tract infection

Physical examination is used to confirm the diagnosis of acute bacterial sinusitis, rule out more serious infections such as pneumonia or meningitis, and determine the need for imaging in patients with high risk for complications such as intracranial abscesses, sagittal sinus thrombosis, etc.