Acute Sinusitis

acute sinusitis

Acute sinusitis are infection of sinuses. They usually go away on its own, but sometimes treatment is required to ease symptoms. Complications are uncommon but include chronic (persistent) sinusitis and the infection spreading to nearby structures.

What role sinuses have in our body?

The sinuses are small, air-filled spaces inside the cheekbones and forehead. They make some mucus which drains into the nose through small channels.

What do you understand by sinusitis?

Inflammation of sinuses is called as sinusitis. They are generally caused 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. Many cases of acute sinusitis last a week or so but it is not unusual for it to last 2-3 weeks (that is, longer than most colds). Sometimes it lasts longer. Sinusitis is said to be acute if it lasts from 4-30 days and subacute if it lasts 4-12 weeks.

Chronic sinusitis means that a sinusitis becomes persistent and lasts for longer than 12 weeks. Chronic sinusitis is uncommon.

What are the causes of acute sinusitis?
  • Cold or the flu, In most people, are known to lead to acute sinusitis. Colds and flu are caused by viruses, which may spread to the sinuses. In a small number of cases, bacteria add on to an infection that started with a virus. This can cause a bacterial sinus infection, which can make the infection worse and last longer.
  • Spread from a dental infection
  • In some cases, infection spreads to a maxillary sinus from an infected tooth.
  • Other risk factors for sinus infection

In some people, one or more factors are present that may cause the sinuses to be more prone to infection. These include:

  • Allergic rhinitis (nasal allergy). The allergy may cause swelling of the tissues on the inside lining of the nose and block the sinus drainage channels. This makes the sinuses more susceptible to infection
  • 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.
  • Asthma.
  • Cystic fibrosis.
  • A poor immune system - for example, people with HIV, people on chemotherapy, etc.
  • Inflammatory disorders such as Wegener's granulomatosis or sarcoidosis.
  • Pregnancy, which makes you more prone to rhinitis (nasal inflammation).
  • Rare tumours of the nose.
  • Previous injuries to the nose or cheeks.
  • Medical procedures such as ventilation or the insertion of a tube through the nose into the stomach (nasogastric tube).
  • Smoking.
How does acute sinusitis present?

Symptoms that commonly occur include:

  • Pain and tenderness over the infected sinus. The pain is often throbbing and worse when you bend your head forward. Chewing may be painful.
  • Nasal symptoms may include:
    • A blocked nose with loss of smell .
    • A runny nose, and if discharge is greeny/yellow, it is more likely that you have a bacterial infection in your sinuses. A runny nose may dry up if the sinus drainage channels become blocked with thick mucus. If this happens, pain and tenderness over the infected sinus may become worse.
  • A high temperature may develop and you may feel generally unwell.
  • 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 do you diagnose acute sinusitis?

Doctor can diagnose acute sinusitis by the history of the patient and by examining the patient. Investigations are not usually needed to diagnose acute sinusitis. Occasionally, blood tests, X-rays or scans are advised if the diagnosis is not clear.

Do you require antibiotics for the treatment of acute sinusitis?

Not usually as most cases of acute sinusitis are due to a viral infection. Like with colds, the immune system usually clears the virus and symptoms generally go within a couple of weeks. Antibiotics do not kill viruses. Also, even if the infection is caused by bacteria, the immune system will usually clear it away.

However, antibiotics are sometimes useful. Your doctor is not likely to prescribe an antibiotic for a mild bout of acute sinusitis. But a course of antibiotics may be prescribed in some cases, for example:

  • If your symptoms are severe or if you are very unwell.
  • If you have another illness such as cystic fibrosis, heart problems or a weakened immune system.
  • If your symptoms are not settling within 7 days, or are worsening.
How to relieve the symptoms?

Some treatments may help to relieve symptoms whilst waiting for your immune system to clear the infection. These include the following:

  • Painkillers will generally ease any pain. They will also treat any fever a person is having. Sometimes stronger painkillers such as codeine are needed for a short time.
  • Decongestant nasal sprays or drops are sometimes used. They may briefly relieve a blocked nose. However, they are not thought to shorten the duration of acute sinusitis.
  • Keeping hydrated can be helpful, so have plenty of drinks.
  • Warm face packs held over the sinuses may help to ease pain.
  • Saline nasal drops may help to relieve congestion and blockage in the nose.
  • Steam inhalation is a traditional remedy but is now not usually advised. This is because there is little evidence that it helps. Also, there have been some reports of people burning themselves trying to breathe in steam from a kettle. However, some people say that their nose feels clearer for a short while after a hot shower.
What are the complications of acute sinusitis?

Chronic sinusitis can sometimes develop from an acute sinusitis. This is the most common complication. Chronic sinusitis causes similar symptoms to acute sinusitis but lasts longer.

Other complications are rare. However, they can be serious. For example, infection may spread from a sinus to around an eye, into bones, into the blood, or into the brain. These severe complications are estimated to occur in about 1 in 10,000 cases of acute sinusitis. They are more common with infection of the frontal sinus. Children are more prone to complications than adults. Swelling or redness of an eyelid or cheek in a child with sinusitis should be reported to a doctor urgently.

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