What You Need to Know About Sinusitis

The symptoms of sinusitis are similar to those of a common cold. They may include:

• decreased sense of smell
• fever
• stuffy or runny nose
• headache from sinus pressure
• fatigue
• cough

It may be difficult for caregivers to detect sinusitis in a child. Signs include:

• cold symptoms that do not improve within 10 to 14 days
• allergy symptoms that do not respond to medication
• a lingering cough
• a fever above 102.2°F (39°C), which is considered a high fever
• thick green or yellow mucus coming from the nose

Sinusitis often occurs when something, such as mucus, blocks the openings of your sinuses.

Anyone can develop sinusitis or a sinus infection. However, certain health conditions and risk factors can increase your chances.

Possible contributors to sinusitis include:

• structural issues affecting the nose, such as:
  • a deviated septum, which occurs when the wall of tissue that runs between the left and right nostrils is uneven
  • a nasal bone spur, or growth
  • nasal polyps, which are usually noncancerous
• weakened immune system
• a history of allergies
• colds and other upper respiratory tract infections, which can be caused by viruses, bacteria, or fungi
• cystic fibrosis, which causes thick mucus to build up in your lungs and other mucous membrane linings
• mold exposure
• tobacco smoking
• dental infection
• airplane travel, which can expose you to a high concentration of germs

Sometimes, a cold, allergens, or bacteria can cause too much mucus to form. This mucus buildup can become thick and encourage bacteria and other germs to build up in your sinus cavity, eventually leading to a sinus infection.

There are different types of sinusitis, and they all have similar symptoms. The severity and duration of the symptoms will vary.

Acute sinusitis

Acute sinusitis has the shortest duration.

It may last up to 4 weeks. A viral infection brought on by the common cold can cause symptoms that typically last up to 10 days.

Viral infections eventually lead to most cases of acute sinusitis, but seasonal allergies are another possible source.

Subacute sinusitis

Subacute sinusitis symptoms can last up to 12 weeks. This condition commonly occurs with seasonal allergies or bacterial infections.

Recurrent acute sinusitis

In recurrent acute sinusitis, you have at least four episodes of acute sinusitis over the course of 1 year. Each episode of acute sinusitis must last at least 7 days.

Chronic sinusitis

Symptoms of chronic sinusitis last for more than 12 weeks. Chronic sinusitis symptoms are often less severe than acute sinusitis symptoms, and fever is rare.

Bacterial infection may be to blame in these cases. Additionally, chronic sinusitis commonly occurs alongside persistent allergies or structural nasal issues.

A doctor will ask about your symptoms and perform a physical exam before they make a diagnosis. They may check for pressure and tenderness by pressing a finger against your head and cheeks. They may also examine the inside of your nose to look for signs of inflammation.

In most cases, the doctor can diagnose sinusitis based on your symptoms and the results of a physical exam.

In the case of chronic sinusitis, the doctor may recommend imaging tests to examine your sinuses and nasal passages. These tests can reveal mucus blockages and any abnormal structures, such as polyps.

• Imaging tests. Various imaging tests can be used in making a diagnosis.
  • An X-ray provides a simple of your sinuses.
  • A CT scan provides a 3-D picture of your sinuses.
  • An MRI uses powerful magnets to create images of internal structures.
• Nasal endoscopy. The doctor may also use a fiberscope, which is a lighted tube that passes through your nose, to directly visualize the inside of your nasal passageways and sinuses. A doctor may obtain a sample for culture testing during this procedure. Culture testing can detect the presence of viruses, bacteria, or fungi.
• Allergy tests. An allergy test identifies environmental factors that may cause an allergic reaction.
• Blood tests. A blood test can check for conditions that weaken the immune system, such as HIV.

Most sinusitis cases are caused by viral infections and may not require treatment. Over-the-counter (OTC) medications and home remedies may help ease your symptoms, though.

Nasal congestion

Nasal congestion is one of the most common symptoms of sinusitis. Try these tips to help reduce nasal congestion:

• To help relieve the feeling of pain from sinus pressure, apply a warm, damp cloth to your face and forehead several times a day.
• Perform a nasal saline rinse to help clear the thick and sticky mucus from your nose.
• Drink water and juice to stay hydrated and help thin the mucus. You can use an OTC medication, such as guaifenesin, that thins mucus.
• Use a humidifier in your bedroom to add moisture to the air. Turn on the shower and sit in the bathroom with the door closed to surround yourself with steam.
• Consider using an OTC nasal corticosteroid spray. There are decongestants available over the counter, but you may want to consider asking a doctor before trying one.

Pain medications

In rare cases, sinusitis can trigger a sinus headache or pressure in your forehead and cheeks. OTC medications such as acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) can help if you’re in pain.

Antibiotics

If your symptoms do not improve within a few weeks, you likely have a bacterial infection and should see a doctor. You may need antibiotic therapy if you have symptoms that do not improve, including:

• runny nose
• congestion
• cough
• continued facial pain or headaches
• eye swelling
• fever

If you receive an antibiotic, you must take it for at least 10 to 14 days, depending on the doctor’s instructions. Do not stop taking your medication earlier than directed, as this can allow the bacterial infection to fester and possibly not fully resolve.

The doctor may have you schedule another visit so they can monitor your condition. If your sinusitis does not improve or gets worse by your next visit, the doctor may refer you to an ear, nose, and throat specialist.

They may also order additional tests to determine whether allergies are triggering your sinusitis.

Surgery

If your chronic sinusitis does not improve with time and medication, you may undergo surgery to:

• clear the sinuses
• repair a deviated septum
• remove polyps

Because sinusitis can develop after a cold, the flu, or an allergic reaction, following a health-promoting lifestyle and reducing your exposure to germs and allergens can help prevent this inflammation.

To reduce your risk, you can:

• Get a flu shot every year.
• Eat nutritious foods, such as fruits and vegetables.
• Wash your hands regularly.
• Limit your exposure to smoke, chemicals, pollen, and other allergens or irritants.
• Take antihistamine medication to treat allergies and colds.
• Avoid exposure to people with active respiratory infections, such as a cold or the flu.

If left untreated, sinusitis may cause rare complications, such as:

• an abscess, which is a walled-off collection of pus in the sinus cavity
• meningitis, a life threatening infection that can cause brain and spinal cord damage
• orbital cellulitis, an infection of the tissue surrounding the eyes

Sinusitis is treatable, and most people recover without seeing a doctor or taking antibiotics. However, tell a doctor if you have repeat or chronic sinus issues. You could have an underlying medical condition, such as nasal polyps.

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