• Pain in the cheekbones, upper teeth, forehead, or around and behind the eye
• Pain intensity may increase with bending over or coughing
• Pain persists after 7-10 days of self treatment
• Postnasal purulent drainage or thick purulent nasal discharge
• In children, a chronic stuffy nose is a common symptom

Patient will be referred to primary care provider if:

• Fever over 103 degrees
• More than four episodes in the last 12 months
• Stiff neck
• Swelling around the eyes
• Facial swelling
• Visual disturbances
• Any difficulty breathing, shortness of breath or wheezing
• Immunocompromised