SINUSITIS

Sinusitis is an inflammation, or swelling, of the tissue lining the sinuses caused by an infection. Germs (bacteria, viruses, and fungi) can cause an infection of the sinuses when they are blocked and filled with fluid.

Common cold, allergic rhinitis (swelling of the lining of the nose), nasal polyps (small growths in the lining of the nose), or a deviated septum (a shift in the nasal cavity) can cause sinus blockage.

There are different types of sinusitis, including:

  • Acute sinusitis: A sudden onset of cold-like symptoms such as runny, stuffy nose and facial pain that does not go away after 10 to 14 days. Acute sinusitis typically lasts 4 weeks or less.
  • Subacute sinusitis: An inflammation lasting 4 to 8 weeks.
  • Chronic sinusitis: A condition characterized by sinus inflammation symptoms lasting 8 weeks or longer.
  • Recurrent sinusitis: Several attacks within a year.

Some of the primary symptoms of acute sinusitis include:

  • Facial pain/pressure
  • Nasal stuffiness
  • Nasal discharge
  • Loss of smell
  • Cough/congestion

Additional symptoms may include:

  • Fever
  • Bad breath
  • Fatigue
  • Dental pain

People with chronic sinusitis may have the following symptoms for 8 weeks or more:

  • Facial congestion/fullness
  • A nasal obstruction/blockage
  • Pus in the nasal cavity
  • Fever
  • Nasal discharge/discolored postnasal drainage

Additional symptoms of chronic sinusitis may include:

  • Headaches
  • Bad breath
  • Fatigue
  • Dental pain

DIAGNOSIS

Physical examination from your doctor and showing symptoms can diagnose sinusitis.

The exam may include the doctor feeling and pressing your sinuses for tenderness. He or she may also tap your teeth to see if you have an inflamed paranasal sinus.

Acute sinusitis may be diagnosed when a person has two or more symptoms and/or the presence of thick, green, or yellow nasal discharge.

Other diagnostic tests to assess the potential causes for sinusitis may include:

  • mucus culture
  • nasal endoscopy
  • X-rays
  • allergy testing
  • CT scan of the sinuses
  • blood work

 

RECOMMENDED MEDICATIONS

Medicines may be needed when symptoms of sinusitis are severe or do not improve. The goals of treatment with medicine are to:

  • Treat the infection, which is usually caused by bacteria if your symptoms have lasted more than 7 to 10 days.
  • Relieve pressure and pain caused by poor sinus drainage.
  • Reduce inflammation of the nose and sinuses.

Medicine choices

Medicines are used and sometimes combined to treat sinusitis. Be safe with medicines.

  • Antibiotics kill bacteria.
  • Decongestants reduce the swelling of the mucous membranes in the nose.
  • Analgesics relieve pain.
  • Corticosteroids reduce inflammation in the nasal passages.
  • Mucolytics thin mucus.

What to think about

If you are taking antibiotics for a sinus infection, do not stop taking the antibiotics early just because you feel better. Take the entire course of antibiotics. The infection may not go away if you do not take all of the antibiotics prescribed by your doctor.

Chronic sinusitis may last 12 weeks or longer and usually requires 3 to 4 weeks of antibiotic treatment. Symptoms may persist or return despite adequate antibiotic treatment. A different antibiotic may be needed to treat the infection. Referral to an ear, nose, and throat (ENT) specialist (also called an otolaryngologist) may be needed if symptoms of sinusitis do not go away despite long-term antibiotic treatment.

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