The ten-day mark as a practical diagnostic approach for acute paranasal sinusitis in children

BACKGROUND: Sinusitis is one of the diseases most frequently overlooked by the primary practitioner. METHODS: We suspected the diagnosis of sinusitis in children with respiratory symptoms that persisted for > 10 days: the 10-day mark. A radiographic projection of maxillary sinuses (Water's view) was indicated, and patients with abnormal radiographs were diagnosed as having sinusitis. After antimicrobial treatment for 2 weeks, we evaluated clinical outcome and follow-up radiographs. RESULTS: The 10-day mark culled 146 suspected children from 2013 outpatients with respiratory complaints. Water's view radiographs revealed sinusitis in 135 patients (92.5% of the suspected children). They included 35 patients with allergy. After treatment only 4 patients in the allergy group (11%) improved completely. In contrast 61 nonallergic patients (61%) were completely improved. CONCLUSIONS: The 10-day mark is a simple and practical diagnostic basis for acute paranasal sinusitis. The associated allergic respiratory diseases respond infrequently to antimicrobial treatment.