Frontal pain, secretions
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Mucosal thickening of the maxillary sinus, ethmoidal and sphenoidal sinuses with out air fluid levels.
In the absence of air-fluid levels it is difficult to make the diagnosis of acute sinusitis, but rather the features are suggestive of chronic sinusitis. This patient may well have sinus pain (obstructed ostia, changes in pressure etc..) but the term acute sinusitis usually is reserved for acute pyogenic infection rather than exacerbations.