Diagnosis of sinusitis is often made based on history and physical exam. Sinus films or CT scans are helpful but expensive.
Nose and nasal cavities. Image source: Wikipedia, public domain.
Left-sided maxillar sinusitis (absence of the air transparency of left maxillar sinus). Image source: Wikipedia, public domain.
The authors studied whether analysis of 4 four easily measured substances in nasal secretions could predict bacterial sinusitis:
1. protein
2. pH
3. leukocyte esterase
4. nitrite
Those 4 substances are the same ones tested by the urine dipstick used to diagnose UTI.
A scoring system was developed to compute the results of the 4 assays in a single clinical score.
All patients with scores of 0 or 1 were CT or x-ray negative for bacterial sinusitis. All patients with scores higher than 4 were imaging study positive.
The authors concluded that combining 4 simple assays on nasal secretion can rule in or rule out bacterial sinusitis in 90% of patients.
Twitter comments: the tweets below are part of the series Medical Geek Humor on Twitter:
A typical medical urinalysis (UA) usually includes:
- pH - normally 4.8 to 7.5.
- protein - normally negative (absent)
- nitrites
- leukocyte esterase
UA shows gross hematuria and bacteria. Image source: ClinicalCases.org.
References:
Rapid diagnosis of bacterial sinusitis in patients using a simple test of nasal secretions. Huang, Shih-Wen; Small, Parker A. Allergy and Asthma Proceedings, Volume 29, Number 6, November/December 2008 , pp. 640-643(4)
Hematuria and Weight Loss due to Bladder Cancer
Nose and nasal cavities. Image source: Wikipedia, public domain.
Left-sided maxillar sinusitis (absence of the air transparency of left maxillar sinus). Image source: Wikipedia, public domain.
The authors studied whether analysis of 4 four easily measured substances in nasal secretions could predict bacterial sinusitis:
1. protein
2. pH
3. leukocyte esterase
4. nitrite
Those 4 substances are the same ones tested by the urine dipstick used to diagnose UTI.
A scoring system was developed to compute the results of the 4 assays in a single clinical score.
All patients with scores of 0 or 1 were CT or x-ray negative for bacterial sinusitis. All patients with scores higher than 4 were imaging study positive.
The authors concluded that combining 4 simple assays on nasal secretion can rule in or rule out bacterial sinusitis in 90% of patients.
Twitter comments: the tweets below are part of the series Medical Geek Humor on Twitter:
 | AllergyNotes Diagnosis of bacterial sinusitis (>90%) using a test of nasal secretions (4 = protein, pH, leuk esterase, nitrite) http://tinyurl.com/aqe6vy |
 | grahamwalker @AllergyNotes Re: bact sinusitis: Hmm. Can you just use a urine dipstick then? |
| AllergyNotes @grahamwalker: "Re: bact sinusitis: Hmm. Can you just use a urine dipstick then?" - I don't think investigators looked at it from that point. You should email them. Full text is subscription only. |
A typical medical urinalysis (UA) usually includes:
- pH - normally 4.8 to 7.5.
- protein - normally negative (absent)
- nitrites
- leukocyte esterase
UA shows gross hematuria and bacteria. Image source: ClinicalCases.org.
References:
Rapid diagnosis of bacterial sinusitis in patients using a simple test of nasal secretions. Huang, Shih-Wen; Small, Parker A. Allergy and Asthma Proceedings, Volume 29, Number 6, November/December 2008 , pp. 640-643(4)
Hematuria and Weight Loss due to Bladder Cancer