Which of the following descriptions is most concerning for acute bacterial sinusitis rather than viral or allergic rhinitis?
A. Itchy, watery eyes with sneezing and clear nasal discharge
B. Fever of 102.1 degrees F with unilateral headache, worse with leaning forward, and onset after URI symptoms approximately 2 weeks prior
C. Fever of 100.2 degrees F with body aches and cough, lasting for 4 days
D. Bilateral frontal headache with yellow-green nasal discharge, lasting for 6 days

B. Bacterial sinusitis is characterized by a high fever, unilateral headache, and symptoms persisting longer than 10 days or worsening after initial improvement.

Concerning for acute bacterial sinusitis as it follows a typical progression from an upper respiratory infection (URI) and includes a high fever and unilateral headache, which are common symptoms. Viral rhinitis usually presents with milder fever and resolves within 1-2 weeks, while allergic rhinitis is symptoms like itchy, watery eyes and sneezing without a high fever.

Key Points to Note:

Bacterial sinusitis often presents after a viral URI with symptoms lasting over 10 days or worsening after initial improvement.
Viral infections generally resolve within one to two weeks.
Allergic rhinitis typically includes symptoms like itching and sneezing, without fever. Option b is correct.