Epidemiology

Etiology

Pathogens
- Viral (most common): rhinovirus, coronavirus, adenovirus, influenza, and parainfluenza viruses
- Bacterial: particularly S. pneumoniae, H. influenzae, M. catarrhalis
Risk factors
- Preexisting viral upper respiratory tract infection (URTI): most common; leads to superimposed bacterial infections
- Impairments of ciliary function such as cystic fibrosis, primary ciliary dyskinesia

Acute viral rhinosinusitis
- May occur with acute otitis media
- May manifest with other symptoms of URTI (e.g., sore throat, cough)
Acute bacterial rhinosinusitis
- Severe symptoms (including fever > 39°C, facial pain, purulent nasal discharge)
- Viral turns to bacterial: Symptoms typically remain stable or improve for 5–6 days and then worsen (double worsening).

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