From the Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, 330 Brookline Ave, LY318, Boston, MA 02215.
In December 1999, at Medicine Grand Rounds, David Kennedy, MD, discussed
the pathophysiology and diagnostic strategies and treatment options for acute
and chronic sinusitis. Mr S, a 48-year-old man, recounted a history of recurrent
episodes of sinusitis during a 21-year period. Early on, surgical drainage
improved symptoms, but over time, the episodes of postnasal drip, facial pain,
yellow nasal discharge, and malaise recurred. Multiple courses of antibiotics
seemed to work less well over time. He averaged about 8 episodes of sinusitis
per year. Dr Kennedy suggested a nasal endoscopy for Mr S. If chronic inflammation,
polyps, or edema were found, surgery would be reasonable to consider.
Parker RA, Hartman EE. A 48-Year-Old Man With Recurrent Sinusitis, 1 Year Later. JAMA. 2001;285(4):462. doi:10.1001/jama.285.4.462