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Sinusitis

Sinusitis



Overview

Sinusitis is an inflammation, or swelling, of the tissue lining your sinuses. Sinuses are structures inside your face that are normally filled with air. Bacterial infections, viral infections and allergies can irritate them, causing them to get blocked and filled with fluid. This can cause pressure and pain in your face, nasal congestion (a stuffy nose) and other symptoms.

Sinusitis is also sometimes called rhinosinusitis.

Types of sinusitis

We describe types of sinusitis based on how long it’s been going on (acute, subacute, chronic or recurrent) and what’s causing it (bacteria, virus or fungus).

Acute, subacute, chronic and recurrent sinusitis

Acute sinusitis symptoms (nasal congestion, drainage, facial pain/pressure and decreased sense of smell) last less than four weeks. It’s usually caused by viruses like the common cold.

Subacute sinusitis symptoms last four to 12 weeks.

Chronic sinusitis symptoms last at least 12 weeks. Bacteria are usually the cause.

Recurrent acute sinusitis symptoms come back four or more times in one year and last less than two weeks each time.

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.

Fungal 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.

Symptoms

Common symptoms of a sinus infection include:

Postnasal drip (mucus dripping down your throat).

Runny nose with thick yellow or green mucus.

Stuffy nose.

Facial pressure (particularly around your nose, eyes and forehead). This might get worse when you move your head around or bend over.

Pressure or pain in your teeth.

Ear pressure or pain.

Fever.

Bad breath (halitosis) or a bad taste in your mouth.

Cough.

Headache.

Tiredness.

Causes

Viruses, bacteria, fungi and allergens can 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.

Risk factors

Some people are more likely to get sinusitis than others. Risk factors include:

Nasal allergies.

Asthma.

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.

Smoking.

Diagnosis

Healthcare providers diagnose sinusitis 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 to diagnose sinusitis

Specific tests your provider might order to diagnose sinus infection include:

Nasal endoscopy.

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 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.

Treatment

There are many treatment options for sinusitis, depending on your symptoms and how long you’ve had them. You can treat a sinus infection at home with:

Decongestants.

Over-the-counter (OTC) cold and allergy medications.

Nasal saline rinses.

Drinking plenty of fluids.

If symptoms of sinusitis don’t improve after 10 days, a provider may prescribe:

Antibiotics.

Oral or topical decongestants.

Prescription intranasal steroid sprays. (Don’t use nonprescription sprays or drops for longer than three to five days — they may actually increase congestion.)

Providers treat chronic sinusitis by focusing on the underlying condition. Treatments can include:

Intranasal steroid sprays.

Topical antihistamine sprays or oral pills.

Leukotriene antagonists, like montelukast.

Surgery to treat structural issues, polyps or fungal infections.

Type of Doctor Department : Primary care physician 


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