Sinusitis In Children And Teenagers Raising Children Network Indications for urgent referral urgent early referral is essential for patients with symptoms that are concerning for complicated abrs or have evidence of complications on imaging. these include patients with high, persistent fevers >102°f; periorbital edema, inflammation, or erythema; cranial nerve palsies; abnormal extraocular movements; proptosis; vision changes (double vision or impaired vision); severe headache; altered mental status; or meningeal signs. (see \"acute sinusitis and rhinosinusitis in adults: clinical manifestations and diagnosis\", section on 'complications' and \"acute sinusitis and rhinosinusitis in adults: clinical manifestations and diagnosis\", section on 'complicated acute bacterial rhinosinusitis'. ) failure of initial berkaitan dengan mulut therapy patients who have sinusitis uptodate worsening symptoms or fail to improve within seven days on initial ther...