Sinusitis is an inflammation, or swelling of the tissue lining your sinuses (spaces in your forehead, cheeks and nose usually filled with air). It causes facial pain, a stuffy or runny nose, and sometimes a fever and other symptoms. It’s usually caused by the common cold, but other viruses, bacteria, fungi and allergies can also cause sinusitis.
Sinusitis itself isn’t contagious. But the viruses and bacteria that can cause it are.
Inflammation can occur because of conditions such as structural issues in the nose or a sinus infection. The terms “sinusitis” and “sinus infection” are sometimes used interchangeably.
Your sinuses are four paired cavities (spaces) in your head. Narrow passages connect them. Sinuses make mucus that drains out of the passages in your nose. This drainage helps keep your nose clean and free of bacteria, allergens and other germs (pathogens).
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- Sinusitis is inflammation of the lining of sinuses in the face. It mainly causes pain and too much mucus production.
- It may follow a cold or allergies.
- Inflammation caused by a virus may resolve in about 10 days and won’t need antibiotics.
- Inflammation caused by bacteria needs antibiotics.
- Treatment aims to relieve the pain and discomfort, and reduce inflammation and mucus production.
- Make sure to take all antibiotics as prescribed and to finish the prescription.
The symptoms of sinusitis may also depend on age. Common symptoms of a sinus infection include:
- Runny nose that lasts longer than 7 to 10 days. The discharge is often thick green or yellow, but can also be clear.
- Cough at night
- Occasional daytime cough
- a fever above 102.2°F (39°C), which is considered a high fever
- Swelling around the eyes
Older children and adults
- Runny nose or cold symptoms that last longer than 7 to 10 days
- Complaints of drip in the throat from the nose
- Facial pain
- Bad breath
- Sore throat
- Swelling around the eyes, worse in the morning
The symptoms of sinusitis may look like other conditions or health problems. Always talk to your healthcare provider, if you notice you have a sinus infection.
There are different types of sinusitis, and they all have similar symptoms. The severity and duration of the symptoms also 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.
Bacterial and viral sinusitis
Viruses, like the ones that cause the common cold, cause most cases of sinusitis. Bacteria can cause sinusitis, or they can infect you after a case of viral sinusitis. If you have a runny nose, stuffy nose and facial pain that don’t go away after ten days, you might have bacterial sinusitis. Your symptoms may seem to improve but then return and are worse than the initial symptoms. Antibiotics and decongestants usually work well on bacterial sinusitis.
Sinus infections caused by fungus are usually more serious than other forms of sinusitis. They’re more likely to happen if you have a weakened immune system.
Viruses, bacteria, fungi causes sinusitis. A sinus infection can happen after a cold. The cold inflames the nasal passages. This can block the opening of the sinuses and lead to infection. Allergies can also cause the nasal tissue to swell and make more mucus and cause sinusitis.
Specific triggers for sinusitis include:
- The common cold.
- The flu (influenza).
- Streptococcus pneumoniae bacteria.
- Haemophilus influenza bacteria.
- Moraxella catarrhalis bacteria.
- Nasal and seasonal allergies.
Other conditions that can lead to sinusitis include:
- Abnormalities in the structure of the nose
- Enlarged adenoids
- Diving and swimming
- Tooth infections
- Nose injury
- Foreign objects that are stuck in the nose
- Secondhand smoke
If mucus drainage is blocked, bacteria may start to grow. This leads to a sinus infection, or sinusitis. The most common viruses and bacteria that cause sinusitis also cause the flu or certain kinds of pneumonia.
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. Some people are more likely to get sinusitis than others. Risk factors include:
- Nasal allergies.
- Nasal polyps (growths).
- Deviated septum. Your septum is a line of tissue that divides your nose. A deviated septum isn’t straight, narrowing the passage on one side of your nose. This can cause a blockage.
- A weakened immune system. This can be from illnesses like HIV or cancer, or from certain medications.
You don’t necessarily need to treat sinusitis, it often goes away on its own. Very rarely, untreated sinus infections can lead to life-threatening infections. This happens if bacteria or fungi spread to your brain, eyes or nearby bone. Sinus infection 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
Take these steps to lower the risk of getting sinus infection:
- Protect your health. Try to stay away from people who have colds or other infections. Wash your hands often with soap and water, especially before meals.
- Eat nutritious foods. Eating nutritious foods such as fruits and vegetables.
- Manage allergies. Work with your health care provider to keep symptoms under control. Stay away from things you’re allergic to when possible.
- Avoid cigarette smoke and polluted air. Tobacco smoke and other pollutants can irritate the lungs and inside the nose, called the nasal passages.
- Use a humidifier. If the air in your home is dry, adding moisture to the air with a humidifier may help prevent sinusitis. Be sure the humidifier stays clean and free of mold with regular, complete cleaning.
- Using saline. Rinsing your nose with saline (salt water) as directed by your provider.
- Using nasal sprays. Using steroid nasal sprays if your provider recommends them.
Healthcare providers diagnose sinus infection based on your symptoms and health history. A provider will check your ears, nose and throat for swelling, draining or blockage. They might use an endoscope (a small, lighted instrument) to look inside your nose.
A primary care provider may also refer you to a specialist, like an otolaryngologist, also called an ENT (an ear, nose and throat specialist).
Specific tests your provider might order to diagnose sinus infection include:
- Nasal endoscopy. A health care provider inserts a thin, flexible tube, known as an endoscope, into the nose. A light on the tube allows a care provider to see inside the sinuses.
- Nasal swabs. Your provider may use a soft-tipped stick to get a fluid sample from your nose. They’ll test it for viruses or other germs that might be causing your symptoms.
- Imaging. In some cases, your provider might order a computed tomography (CT) scan, X-ray or MRI to better understand what’s happening inside your sinuses.
- Allergy testing. If you have chronic sinusitis, your provider may test you for allergies that could be triggering it.
- Biopsy. Rarely, a provider may take a tissue sample from your nose for testing.
- 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.
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.
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.
If you need an antibiotic, which one your provider prescribes depends on your specific situation. Some options include:
- Augmentin (amoxicillin/clavulanate).
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
- continued facial pain or headaches
- eye swelling
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.
Your healthcare provider may also order additional tests to determine whether allergies are triggering your sinusitis.
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
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.
For sinusitis caused or made worse by allergies, allergy shots might help. This is known as immunotherapy.
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