Sinusitis and fever of unknown origin

Patients in the ICU are often intubated because of limited mental status and may have limited airway protective mechanisms. These patients cannot communicate their symptoms, leaving the clinician without an essential part of the history of the disease for which they are evaluating the patient. The diagnosis of acute bacterial rhinosinusitis continues to generate controversy in critically ill patients. Some of the controversy sterns from the lack of a definition of this disease, the lack of a uniform diagnostic test, disagreement about which surgical or medical intervention should be instituted, and uncertainty about the origins of the disease. This article reviews sinusitis as a cause of fever in the critically ill patient.