Children’s Sinusitis Guideline in Iambic Pentameter

The American Academy of Pediatrics acute sinusitis guideline was too complex for limerickification, and even resisted sonnet format, so here it is in iambic pentameter.

Nasal discharge’s mostly allergic or viral

And thus needs only symptomatic care

With no need for an antimicrobial trial

Unless high-risk and flu virus is there.


Only think sinusitis as a cause

In three scenarios based on the patient’s tale

Note none involve a mucus color clause

So green snot counts not–neither dark nor pale.


First, symptoms exceed 10 days and don’t improve

Or second, improve but then thereafter worsen

(‘Tho this usually means that in has moved

A second virus attacking the same poor person).


Third is when the onset is severe

With fever 39 degrees or higher

And nasal discharge purulent not clear

Both unrelenting for three days required.


For children meeting persistent criteria

Consider observing three days more

And, weighing risks such as diarrhea,

Start antibiotics only if symptoms endure.





Published by Marion Sills

I am a Professor of Pediatrics and Emergency Medicine at the University of Colorado. I work as a physician in the emergency departments of the Children's Hospital of Colorado and as a health services researcher at the University's Adult and Child Consortium for Health Outcomes (ACCORDS).

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