Sinusitis is categorized by duration of sinonasal inflammation. Sinonasal inflammation with sudden onset of symptoms lasting up to 4 weeks is considered acute rhinosinusitis (ARS).6 Key diagnostic symptoms include purulent nasal drainage, nasal congestion, and facial pain or pressure. One of the challenges in the diagnosis of ARS is differentiating viral from bacterial etiologies. This distinction is important as viral causes of ARS will largely resolve spontaneously whereas bacterial episodes may benefit from antibiotics. The most recent Clinical Practice Guideline from the American Academy of Otolarynology-Head and Neck Surgery suggests a diagnosis of bacterial ARS be considered when symptoms persist longer than 10 days or worsen after a period of initial improvement.6