Resources and Memory //

This is an otherwise healthy, well appearing patient presenting with uncomplicated sinusitis. [***I have low clinical suspicion for deep space tissue infection of the head/neck, cavernous sinus thrombosis, meningitis, or other high-risk bacterial infection.] Based on patient’s physical exam and clinical symptoms, [***There is concern for CNS involvement and advance imaging was obtained.] [***No Antibiotic treatment: Antibiotics not indicated at this time because etiology is likely viral and/or symptoms have been ongoing < 10 days with no worsening of symptoms, CNS involvement, or other significant complications.] [***Antibiotic treatment with amoxicillin-clavulanate is indicated for likely bacterial etiology given that the patient’s symptoms have been ongoing > 10 days with worsening symptoms after initial improvement]. [***Patient prescribed alternative antibiotic due to allergy history] Patient is aware that the purpose of this visit was to screen for an acute medical emergency requiring emergent stabilization. Chronic conditions, including malignancies, have not been ruled out. Patient is instructed to follow-up with a PCP as directed in discharge instructions for continued care and work-up. If unable to arrange follow-up, patient is instructed to return to the ED for reassessment. Patient was given verbal and written discharge instructions and acknowledges understanding.



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