🤧 Acute vs Chronic Sinusitis Diagnostic Pathway Simulator

Symptom Onset

Sinus symptoms begin — pressure, congestion, discharge, placeholder text.

• Viral URI: Common triggers (most frequent cause)
• Abrupt: Onset pattern (hours to 1–2 days)
• 4: Cardinal symptoms (pressure, congestion, discharge, smell loss)
• 28 days: Acute cutoff (defines acute window)

What triggers onset

Placeholder: viral infection usually starts the cascade.

Placeholder key insight about onset speed.

Early symptom pattern

Placeholder: pressure and congestion appear first.

Why duration matters

Placeholder: duration anchors the whole diagnostic pathway.

Duration Timeline Tracked

Days since onset accumulate, placeholder short lead text here.

• Days: Tracking unit (converted to weeks)
• 4–12 wk: Subacute range (transitional zone)
• ≥4 / yr: Recurrent ARS (episodes definition)
• 84 days: Chronic cutoff (12-week threshold)

Why track days precisely

Placeholder: duration drives classification, not severity alone.

Placeholder insight on timeline precision.

The subacute zone

Placeholder: 4–12 weeks is a watchful transition period.

Recurrence vs chronicity

Placeholder: repeated acute bouts differ from true chronic disease.

4-Week & 12-Week Threshold

The timeline crosses two decision thresholds, placeholder lead text.

• < 4 wk: Acute threshold (clinical diagnosis only)
• 4–12 wk: Subacute threshold (monitor closely)
• > 12 wk: Chronic threshold (imaging required)
• 2: Branch decision points (4-week and 12-week gates)

The 4-week gate

Placeholder: crossing 4 weeks flags watchful monitoring.

Placeholder insight on the branch logic.

The 12-week gate

Placeholder: crossing 12 weeks mandates chronic workup.

Why thresholds are fixed

Placeholder: consensus guidelines standardize these cutoffs.

Diagnostic Workup Diverges

Acute stays clinical; chronic needs endoscopy and CT, placeholder text.

• Clinical: Acute workup (history and exam only)
• Endoscopy + CT: Chronic workup (objective confirmation)
• Mucosal thickening: Key CT finding (seen past 12 weeks)
• Nasal polyps: Key endoscopy finding (chronic subtype marker)

Acute clinical diagnosis

Placeholder: symptoms and exam suffice for acute cases.

Placeholder insight on avoiding unneeded imaging.

Chronic imaging requirement

Placeholder: CT and nasal endoscopy confirm chronic disease.

What imaging reveals

Placeholder: mucosal thickening and polyps signal chronicity.

Divergent Treatment Outcomes

Acute resolves with short-course care; chronic needs specialists, placeholder.

• Short-course: Acute treatment (symptomatic, self-limited)
• Long-term: Chronic treatment (specialist-managed)
• ~10 days: Acute resolution (typical course)
• ENT: Chronic referral (specialist workup needed)

Acute outcome path

Placeholder: most acute cases self-resolve without antibiotics.

Placeholder insight on acute prognosis.

Chronic outcome path

Placeholder: chronic disease needs long-term specialist management.

Why pathways diverge

Placeholder: duration-driven pathology explains differing care.