Acute sinusitis  is diagnosed based upon the presence and duration of symptoms, examination of the nose and sinuses and history. Labatory testing and x-rays are usually not necessary for an initial bout of sinusitis. However, if sinusitis persists with therapy or recurs shortly after a course of treatment further diagnostics including computerized tomography of the sinuses (CT scan) andallergy testing may be indicated. Acute sinusitis is treated with oral antibiotics, decongestants, mucolytic agents (loosens and liquifies sinus mucus) and often steroid nasal sprays to reduce inflammation two of my friends have this and they told me that its not that easy especially at night when it attacked.Most patients with acute sinusitis will adequately respond to a single 14 day course of antibiotic therapy. the patient discontinues the medication early as they begin to feel better only to allow the bacteria to regrow with a vengeance. Patients who do not improve after a trial of first line antibiotics may require an extended course of a second line agent. they should be referred to a sinus specialist for further evaluation and treatment.