A 11-year-old boy came to OPD with a "cold" for 20 days. Now he has fever of 39.2degC, purulent anterior nasal discharge, facial pain, anosmia, and a cough. Examination of the nose after topical decongestants shows pus in the middle meatus. What is the best possible diagnosis?
High-Yield Explanation
On the basis of above clinical scenario best possible diagnosis is Maxillary sinusitis. Conventional Criteria for the Diagnosis of Sinusitis Based on the Presence of at Least 2 Major or 1 Major and >=2 Minor Symptoms MAJOR SYMPTOMS MINOR SYMPTOMS Purulent anterior nasal discharge Purulent or discolored posterior nasal discharge Nasal congestion or obstruction Facial congestion or fullness Facial pain or pressure Hyposmia or anosmia Fever (for acute sinusitis only) Headache Ear pain, pressure, or fullness Halitosis Dental pain Cough Fever (for subacute or chronic sinusitis) Fatigue Investigations:- Sinus aspirate culture- Best accurate method for diagnosis X-ray CT scan Treatment:- Antibiotic- Amoxicillin clavulanate (45 mg/kg/day PO bid)- First line drug