The common cold in patients with a history of recurrent sinusitis - Increased symptoms and radiologic sinusitis like findings

BACKGROUND We evaluated whether the symptoms and signs and radiologic findi ngs during a common cold are similar in patients who have and have not suff ered from recurrent sinusitis. METHODS We recruited 2 series of volunteer cases from February 1, 1996, to December 31, 1996, Twenty-three adults who claimed to have suffered from re current sinusitis and 25 who had never had sinusitis were examined during t he period of a self-diagnosed cold of 48 to 96 hours' duration and again af ter 21 days. Symptom scores were recorded, nasoendoscopy and computed tomog raphy scans were performed, and viral and bacterial specimens were taken. RESULTS The patients with a history of sinusitis had significantly higher m ean symptom scores than the control patients (P=.04) and had radiologic sin usitislike changes more often (65% [15] vs 36% [9]; difference 29% [95% con fidence interval, 2%-56%]; P=.04). The viral etiology of the common cold (v erified in 67% df the episodes) was similar in both groups. Pathogenic bact eria were isolated from the middle meatus in 24% (6) of the control patient s and only 9% (2) of the sinusitis-prone patients (P=.15). On the basis of the symptomatology, radiologic findings, and bacterial cultures only 2 pati ents in the sinusitisprone group should have been treated with antimicrobia ls. CONCLUSIONS Some patients are susceptible to both sinusitislike symptoms an d radiologic findings during viral common colds. This may cause them to con sult their physicians earlier and more often during viral colds, which may result in unnecessary antibiotic treatments. Nasopharyngeal bacteriological cultures may prove to be useful in ruling out bacterial sinusitis.