الأذن والأنف والحنجرة

A 4-year-old previously healthy girl is brought to your office for a 12-day history of persistent thick nasal discharge, nasal congestion, cough, and intermittent low-grade fever. On further questioning, her parents reveal that the cough is worse at night, but there is no wheezing. She denies any vomiting, headache, earache, or rashes. On examination her vitals are, temperature: 37.2C (99F); PR: 90/min; RR: 15/min; BP: 88/50mm Hg. She is an alert, interactive child breathing comfortably. Her tympanic membranes are clear. She has a nasal congestion with thick and purulent mucus in the posterior nasal pharynx. Her nasal turbinates are red and swollen. She has mild tenderness of her maxillary sinuses. Her lungs are clear. What is the next best step in management of this patient?

A. X-ray paranasal sinuses
B. CT scan of sinuses
C. Sinus aspiration
D. Start the patient on decongestants
E. Start patient on oral amoxicillin