AccessMedicine's Case of the Week: Rhinosinusitis

From: Resident Readiness: Internal Medicine: Outpatient Medicine
AccessMedicine's Case of the Week: Rhinosinusitis
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Case:

A 36-year-old female presents with a 5-day history of clear nasal discharge, nasal congestion, and frontal headaches associated with nonproductive cough. There is no reported fever. On previous similar episodes the patient noted improvement with antibiotics. She has seasonal allergies, and uses loratidine as needed. Vital signs are normal. There is mild bilateral suborbital ridge tenderness present on examination. The nares are patent with a clear mucoid discharge; there is no pharyngeal erythema or exudates, and lungs are clear to auscultation.

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What is the most appropriate next step?


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