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Clinical Crossroads Update
January 24/31, 2001

A 48-Year-Old Man With Recurrent Sinusitis, 1 Year Later

Author Affiliations

From the Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, 330 Brookline Ave, LY318, Boston, MA 02215.

JAMA. 2001;285(4):462. doi:10.1001/jama.285.4.462

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.

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