| Summary: | Chronic sinusitis is a heterogeneous group of inflammatory disorders of the nose and the paranasal sinuses, with different variations( CRSwNP or CRSsNP) and different underlying pathophysiology. This diversity in the pathophysiology of Chronic Rhinosinusitis led to the finding that it consists of biological subtypes or endotypes, defined by distinct pathophysiological mechanisms that could be identified with corresponding biomarkers. 0,5% of upper respiratory tract infections are complicated by acute rhinosinusitis. In Europe, the frequency of CRS is 10.9%. In the last decade, an increase in its frequency by 18% has been observed. It is the third most common diagnosis for the administration of antibiotics. Regarding the causative factors of CRS, many microbes are included. Anaerobes play a leading role (Bacteroides, Anaerobic gram-positive cocci, Fusobacterium species), which cause more than 50% of infections. Less common strains are Staphylococcus aureus, Haemophilus influenza, Pseudomonas aeruginosa, Escherichia coli, Betahemolytic Streptococcus, και Neisseria spp. Fungi play a leading role in immunosuppressed patients ( Aspergillus sp., Fusarium sp. ) and anaerobes. 50% of infections are polymicrobial infections. In patients with Cystic Fibrosis, the most common microbes are Pseudomonas aeruginosa and Staphylococcus aureus.
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