Sinobronchitis: Viral, Bacterial, and Allergic Causes with Risk Factors

Sinobronchitis = simultaneous inflammation of sinuses and lower airways (bronchi). Often follows viral URI.

Etiology

• Viral (most common): Rhinovirus, influenza, RSV, parainfluenza, adenovirus, coronavirus.
• Bacterial (superinfection): S. pneumoniae, H. influenzae, M. catarrhalis, S. aureus, M. pneumoniae, C. pneumoniae, Legionella.
• Allergic/Irritant: Pollen, dust mite, dander, mold; smoke, pollution, chemicals.

Risk Factors

• Smoking (active/passive) – impairs mucociliary clearance.
• Chronic lung disease (asthma, COPD, CF, bronchiectasis).
• Immunocompromise (HIV, diabetes, chemo, steroids).
• Anatomic: deviated septum, nasal polyps.
• Environmental: cold air, dry heat, occupational exposures.
• Age: children (immune naivety), elderly (comorbidities).

Clinical Features

• Nasal congestion, purulent discharge, facial pain/pressure.
• Cough (productive), wheeze, dyspnea.
• Fever, malaise.

Management

• Viral: supportive (saline irrigation, hydration, analgesics).
• Bacterial: antibiotics (amoxicillin‑clavulanate, doxycycline, respiratory fluoroquinolone) if >10 days, worsening, or severe.
• Allergic: intranasal corticosteroids, antihistamines, allergen avoidance.
• Bronchodilators if wheezing.
• Smoking cessation critical.

Distinguish from acute bronchitis (no sinus symptoms) and chronic sinusitis (>12 weeks).