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Evid Based Nurs 6:24 doi:10.1136/ebn.6.1.24
  • Assessment (screening or diagnosis)

Review: specific signs and symptoms can help practitioners to diagnose acute purulent sinusitis in general practice

Symptoms, signs, and blood tests independently associated with a confirmed diagnosis of acute sinusitis*

Symptom, sign, or blood test (number of studies investigating item) Number of studies finding an association +LR
*+LR = positive likelihood ratio; defined in glossary
Symptoms
Purulent rhinorrhoea (4) 3 1.5, 1.5, 1.9
Pain in teeth (4) 2 2.1, 2.5
Beginning with common cold (4) 1 1.4
Unilateral maxillary pain (4) 1 1.8
2 phases in the illness history (1) 1 2.1
Lack of response to nasal decongestants (1) 1 2.1
Signs
Purulent secretion in nasal cavity (4) 2 2.1, 5.5
Pain at bending forward (4) 1 1.6
Transillumination of sinus (1) 1 1.6
Blood Tests
Elevated erythrocyte sedimentation rate, >10 mm/h for males and >20 mm/h for females (2) 2 1.7, 2.9
Increased C-reactive protein, >10 mg/l (2) 1 1.8

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