Timo J Autio1,2,3, Timo Koskenkorva4,5,6, Petri Koivunen4,5,6, Olli-Pekka Alho4,5,6. 1. Department of Otorhinolaryngology and Head and Neck Surgery, Oulu University Hospital, P.O. Box 21, FI-90029, OYS, Oulu, Finland. timo.autio@ppshp.fi. 2. PEDEGO Research Unit, University of Oulu, Oulu, Finland. timo.autio@ppshp.fi. 3. Medical Research Center Oulu, Oulu, Finland. timo.autio@ppshp.fi. 4. Department of Otorhinolaryngology and Head and Neck Surgery, Oulu University Hospital, P.O. Box 21, FI-90029, OYS, Oulu, Finland. 5. PEDEGO Research Unit, University of Oulu, Oulu, Finland. 6. Medical Research Center Oulu, Oulu, Finland.
Abstract
PURPOSE OF REVIEW: Diagnosis of bacterial acute rhinosinusitis is difficult. Several attempts have been made to clarify the diagnostic criteria. Inflammatory biomarkers are easily obtainable variables that could shed light on both the pathophysiology and diagnosis of bacterial acute rhinosinusitis. The purpose of this review article is to assess literature concerning the course of inflammatory biomarkers during acute rhinosinusitis and the use of inflammatory biomarkers in diagnosing bacterial acute rhinosinusitis. RECENT FINDINGS: We included C-reactive protein, erythrocyte sedimentation rate, white blood cell counts, procalcitonin, and nasal nitric oxide in this review and found that especially elevated C-reactive protein and erythrocyte sedimentation rate are related to a higher probability of a bacterial cause of acute rhinosinusitis. Still, normal levels of these two biomarkers are quite common as well, or the levels can be heightened even during viral respiratory infection without suspicion of bacterial involvement. Elevated levels of C-reactive protein or erythrocyte sedimentation rate support diagnosis of bacterial acute rhinosinusitis, but due to a lack of sensitivity, they should not be used to screen patients for bacterial acute rhinosinusitis.
PURPOSE OF REVIEW: Diagnosis of bacterial acute rhinosinusitis is difficult. Several attempts have been made to clarify the diagnostic criteria. Inflammatory biomarkers are easily obtainable variables that could shed light on both the pathophysiology and diagnosis of bacterial acute rhinosinusitis. The purpose of this review article is to assess literature concerning the course of inflammatory biomarkers during acute rhinosinusitis and the use of inflammatory biomarkers in diagnosing bacterial acute rhinosinusitis. RECENT FINDINGS: We included C-reactive protein, erythrocyte sedimentation rate, white blood cell counts, procalcitonin, and nasal nitric oxide in this review and found that especially elevated C-reactive protein and erythrocyte sedimentation rate are related to a higher probability of a bacterial cause of acute rhinosinusitis. Still, normal levels of these two biomarkers are quite common as well, or the levels can be heightened even during viral respiratory infection without suspicion of bacterial involvement. Elevated levels of C-reactive protein or erythrocyte sedimentation rate support diagnosis of bacterial acute rhinosinusitis, but due to a lack of sensitivity, they should not be used to screen patients for bacterial acute rhinosinusitis.
Authors: Eli O Meltzer; Daniel L Hamilos; James A Hadley; Donald C Lanza; Bradley F Marple; Richard A Nicklas; Allen D Adinoff; Claus Bachert; Larry Borish; Vernon M Chinchilli; Melvyn R Danzig; Berrylin J Ferguson; Wytske J Fokkens; Stephen G Jenkins; Valerie J Lund; Mahmood F Mafee; Robert M Naclerio; Ruby Pawankar; Jens U Ponikau; Mark S Schubert; Raymond G Slavin; Michael G Stewart; Alkis Togias; Ellen R Wald; Birgit Winther Journal: J Allergy Clin Immunol Date: 2006-11 Impact factor: 10.793
Authors: T Puhakka; M J Mäkelä; A Alanen; T Kallio; L Korsoff; P Arstila; M Leinonen; M Pulkkinen; J Suonpää; J Mertsola; O Ruuskanen Journal: J Allergy Clin Immunol Date: 1998-09 Impact factor: 10.793