<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:An 8-year-old boy with asthma is brought to the physician because of a 2-week history of facial pain and congestion. His mother states that the nasal discharge was initially clear, but it has become thicker and more purulent over the last week. He has tried multiple over-the-counter oral decongestants and antihistamines, with minimal relief. Current medications include cetirizine, intranasal oxymetazoline, and albuterol. His temperature is 37.7C 99.8F, pulse is 100min, respirations are 14min, and blood pressure is 11070 mm Hg. Examination shows congested nasal mucosa with purulent discharge from the nares bilaterally. There is tenderness to palpation over the cheeks, with no transillumination over the maxillary sinuses. Which of the following is the most likely predisposing factor for this patients current condition?? A: Nasal polyps, B: Viral upper respiratory tract infection, C: Asthma, D: Foreign body, E: Recent use of antihistaminesn,  <response>: This is a clinical vignette about an 8-year-old boy with a 2-week history of facial pain and congestion. Important details from the stem include: - Initial clear nasal discharge that became thicker and purulent over 1 week- Minimal relief from OTC decongestants and antihistamines- Vital signs showing fever and tachycardia - Purulent nasal discharge and facial tenderness on exam- No transillumination of maxillary sinusesThis clinical presentation is most consistent with acute bacterial sinusitis, which often follows a viral upper respiratory infection. The thick purulent discharge, fever, facial tenderness and lack of transillumination point towards bacterial sinusitis rather than just a viral URI. Asthma may contribute to symptoms but is less likely the primary predisposing factor in this case. Nasal polyps and foreign body are not supported. Recent antihistamine use may dry secretions but not directly predispose to sinusitis.Therefore, the most likely predisposing factor in this patient is a viral upper respiratory tract infection.B: Viral upper respiratory tract infection 