Acute Sinusitis

acute sinusitis

Acute sinusitis is usually self limiting. There are various treatments that may help to ease symptoms. Antibiotics are rarely needed. Complications are uncommon.

What are sinuses?

The sinuses are small, air-filled spaces inside the facial bones and forehead.

What is sinusitis?

Sinusitis means inflammation of a sinus. Most incidents of sinusitis are caused by an infection. The cheekbone (maxillary) sinuses are the most commonly affected.

Acute sinusitis means that the infection develops quickly (over a few days) and lasts a short time. Sinusitis is said to be acute if it lasts from 4-30 days. A mild bout of acute sinusitis is a very common ailment and many people will have some degree of sinusitis with a cold. Chronic sinusitis means that a sinusitis becomes persistent and lasts for longer than 12 weeks. Chronic sinusitis is uncommon and has fairly significant health implications.

How can you get acute sinusitis?
  1. After a cold or the flu
  2. Spread from a dental infection
  3. Allergic rhinitis (nasal allergy). This predisposes the sinuses to getting infected with bacteria.
  4. Other causes of a blockage to the sinus drainage channels, such as nasal polyps, objects pushed into the nose (especially in children, such as peas or plastic beads), facial injury or surgery and certain congenital abnormalities in children, rare tumors of the nose.
  5. Asthma.
  6. Rare causes like Cystic fibrosis, Wegener's granulomatosis, sarcoidosis.
  7. People with HIV, people on chemotherapy, etc.
  8. Pregnancy.
  9. Trauma to the nose or cheeks.
  10. Medical procedures such as mechanical ventilation or the insertion of a tube through the nose into the stomach (nasogastric tube).
  11. Smoking.
What are the symptoms of acute sinusitis?
  • Pain- The pain is often throbbing and worse when you bend your head forward.
  • A blocked nose- Both sides of your nose usually feel blocked.
  • Your sense of smell may also go for a while.
  • A runny nose- If the discharge is creamy yellow or green, it is more likely that you have a bacterial infection in your sinuses.
  • A fever may develop.
  • Other symptoms that may occur include: headache, bad breath, toothache, cough, a feeling of pressure or fullness in the ears, and tiredness.
  • In children, symptoms may include irritability, ear discomfort, snoring, mouth breathing, feeding difficulty and nasal speech.
How is acute sinusitis diagnosed?

Your doctor can usually diagnose acute sinusitis from listening to your symptoms. She/he may examine your nose, as often the lining of the nose is swollen in acute sinusitis. Investigations are not usually needed to diagnose acute sinusitis. Occasionally, blood tests, X-rays or scans are advised if the diagnosis is not clear.

How is it treated?

Most cases of acute sinusitis are due to a viral infection. Antibiotics do not kill viruses. In healthy normal individuals the immune system is fully capable of handling mild to moderate bacterial and viral infections. So, for most people with acute sinusitis, antibiotics are not needed. Antibiotics can also cause side-effects.

However antibiotics are prescribed in the following conditions:
  1. If your symptoms are severe.
  2. If you have another illness such as cystic fibrosis, heart problems or a weakened immune system.
  3. If your symptoms are not settling within 7 days, or are increasing in severity.
Treatment to relieve symptoms

Painkillers such as paracetamol or ibuprofen will usually ease any pain. They will also help to bring down any fever that you may have.

Decongestant nasal sprays or drops are sometimes used. You can buy these from pharmacies. They may briefly relieve a blocked nose. It is not advisable to use a decongestant spray or drops for more than 5-7 days at a time.

Keeping hydrated-drink plenty of clear fluids.

Warm face packs held over the sinuses.

Saline nasal drops may help to relieve congestion and blockage in the nose.

Steam inhalation is a traditional remedy of limited usefulness.

Are there any complications from acute sinusitis?

Chronic sinusitis can sometimes develop from an acute sinusitis. Chronic sinusitis causes similar symptoms to acute sinusitis but lasts longer. Some other complications are rare but they can be serious. Infection may spread from a sinus to around an eye, into bones, into the blood, or into the brain. Children are more prone to complications than adults. Swelling or redness of an eyelid or cheek in a child with sinusitis should prompt you to seek medical advice urgently.

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