Sinusitis (Sinus Infection)

By:    Published: November 7, 2012

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Sinusitis is an infection in the sinuses. The sinuses are air-filled areas in the skull that are located behind the forehead, cheeks, eyes and nasal bones. These areas are lined with mucous membranes. When healthy, they are free from bacteria and germs, and mucus drains freely, allowing air to properly circulate. Sinusitis occurs when the sinuses and nasal passages are inflamed, which can block mucus from draining and allow infection to set in.

Definition

Sinusitis is the inflammation and infection of the sinuses. Infection can develop as a result of a virus, bacteria or fungus. Most cases of sinusitis will clear up without antibiotics; however, acute or sub-acute bacterial sinusitis will require antibiotic therapy for 4 to 12 weeks. Viral sinusitis generally lasts for less than 4 weeks and often occurs after having a viral upper respiratory infection. Chronic sinusitis generally lasts for longer than 4 weeks.

Symptoms

Symptoms of sinusitis usually develop after a cold. Sometimes they develop on their own with no prior infection present. Sinusitis symptoms include:

  • Headache
  • Pressure behind the eyes
  • Facial tenderness
  • Toothache
  • Nasal congestion
  • Nasal discharge
  • Sore throat
  • Cough
  • Postnasal drip
  • Bad breath
  • Fatigue
  • Fever

The symptoms are the same for viral, bacterial and fungal sinusitis. If a cold or upper respiratory infection is improving and then suddenly gets worse, a sinus infection is likely the cause.

Causes

The majority of sinusitis cases are caused by a viral infection. Allergies, airborne pollutants or irritants, fungal infections and bacterial infections can also cause sinusitis. Some individuals may have a medical condition that prevents the cilia (tiny hairs) in the sinuses form working properly, interfering with mucus drainage, which can cause sinusitis to develop. Structural abnormalities such as a deviated septum can block the sinus openings and cause mucus build-up. Nasal polyps and nasal bone spurs can have the same effect. Occasionally, a cold or allergy flare-up can produce excess mucus that clogs up the sinuses and does not drain. When this happens, bacteria can settle in and infect the mucus, leading to a sinus infection.

Risk Factors

There are certain risk factors that make individuals more susceptible to developing sinusitis. Risk factors include:

  • Hay fever
  • Non-allergic rhinitis
  • Allergies
  • Cystic fibrosis
  • Deviated septum
  • A child in day care
  • Altitude changes
  • Enlarged adenoids or tonsils
  • Smoking
  • Tooth infections
  • Weak immune system

Diagnostic Testing

Your doctor will be able to diagnose a sinus infection after a thorough physical exam. Your doctor will examine your ears, throat, eyes and the inside of your nose to check for swelling, excess mucus and a postnasal drip. He will press on your forehead, under your eyes and near your temples to check for pain. He will tap on the sinuses to feel for fluid accumulation.

If sinusitis is chronic, you may be referred to an Ear, Nose and Throat (ENT) specialist. An ENT may perform additional diagnostic tests such as:

  • X-rays
  • Nasal endoscopy
  • Rhinoscopy
  • CT scan
  • MRI
  • Allergy testing
  • Blood tests

Treatment

The type of treatment needed to treat sinusitis depends on the underlying cause. Viral sinusitis will generally clear up on its own without medical treatment. Home care remedies can help alleviate symptoms and speed healing. Bacterial sinusitis may require antibiotic treatment to kill the bacteria and relieve the infection. Fungal sinus infections can require antifungal medications and occasionally, surgery. Pain relievers may be prescribed to reduce pain and pressure. Anti-inflammatory medication can help relieve swelling in the sinuses and nasal passages.

Home Remedies

Over 80 percent of sinus infections do not require antibiotics. Home care remedies are often the most effective way to find relief from sinusitis symptoms. Home care is aimed at reducing swelling, alleviating pain, relieving congestion and minimizing symptoms. Effective home remedies for sinusitis include:

  • Apply a warm, moist towel to the face
  • Drink lots of fluids
  • Take a hot shower and inhale the steam
  • Place your face over a pot of hot water and inhale steam
  • Use a saline nasal spray
  • Use a humidifier
  • Flush out sinuses with a Neti pot (nasal irrigation)
  • Refrain from bending forward
  • Avoid flying

Considerations

Sinusitis is a painful condition that can last for several weeks. Preventing a sinus infection requires the same steps as preventing a cold or other minor illness. Practice good hygiene, avoid close contact with sick individuals, don’t smoke and steer clear of second hand smoke.

Although complications from sinusitis are rare, they can occasionally occur. Complications can include:

  • Bone infection
  • Abscess
  • Meningitis
  • Skin infection

Prompt treatment of sinusitis can help prevent complications from developing. It is important to call your doctor if you have a fever or develop a headache that is not relieved by over-the-counter medications. Contact your doctor if your symptoms last longer than 10 days or if you have a cold that starts to clear up but suddenly gets worse.

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