Atypical facial pain (acute rhinosinusitis)
Acute rhinosinusitis is an acute inflammation of the nose and paranasal sinuses. It is defined as a sudden onset of symptoms for less than 12 weeks duration.
The diagnosis includes 1 of nasal blockage/congestion OR nasal discharge as well as 1 of facial pain/pressure OR loss/reduction of sense of smell.
In symptoms lasting <5 days or improving thereafter, appropriate treatment is with paracetamol, nasal saline irrigation and decongestants. For symptoms lasting >10 days, or worsening after 5 days, topical steroids and antibiotics should be considered.
However, if there are red flags signs such as periorbital oedema/erythema, displaced globe, double vision or meningitis, an immediate referral to ENT is required.