Acute Sinusitis: Causes, Symptoms, Diagnosis, Treatment and Complications

It is a sinus infection that usually goes away on its own without treatment.

There are several treatments that can help relieve symptoms ( antibiotics are only necessary sometimes).

Complications are rare, but consist of persistent (chronic) sinusitis and spread of infection to nearby structures.

What are paranasal sinuses?

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

What is sinusitis?

Sinusitis is inflammation of a paranasal sinus. Most sinus attacks are caused by an infection. The sinuses of the cheekbone are the most commonly affected.

Acute sinusitis means that the infection develops quickly (over a few days) and lasts for a short time.

Many cases of acute sinusitis last about a week, but it is not unusual for it to last 2 or 3 weeks (longer than most colds).

Sinusitis is said to be acute if it lasts 4 to 30 days and subacute if it lasts 4 to 12 weeks.

A mild episode of acute sinusitis is common, many people have some degree of sinusitis with a cold. However, constant acute sinusitis is rare.

Most people only have one or two episodes of acute sinusitis in their lives. However, some people have recurrent attacks of acute sinusitis.

Chronic sinusitis means that a sinusitis becomes persistent and lasts for more than 12 weeks. Chronic sinusitis is rare.

Causes of acute sinusitis

After a cold or the flu

In most people, acute sinusitis develops after a cold or flu-like illness.

Colds and flu are caused by germs called viruses that can spread to the sinuses.

The infection usually remains viral before disappearing, causing a viral sinus infection.

In a small number of cases, germs called bacteria add to an infection that started with a virus. This can cause a sinus infection that can make the infection worse.

Spread of a dental infection

In some cases, the dental infection, that is, an infected tooth, spreads to a paranasal sinus of the cheekbone causing acute sinusitis.

Other risk factors

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

  • Nasal Allergy – Allergy can cause swelling of the tissues in the inner lining of the nose and block sinus drainage channels. This makes the sinuses more susceptible to infection.
  • Growth of nasal polyps.
  • Objects inserted into the nose (especially in children, such as peas or plastic sockets).
  • Facial injury or surgery.
  • Certain congenital abnormalities in children, that is, abnormalities that are present from birth.
  • 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 makes nasal inflammation (rhinitis) more prone.
  • Rare tumors of the nose.
  • Previous injuries to the nose or cheeks.
  • Medical procedures such as ventilation or inserting a tube through the nose into the stomach (nasogastric tube).
  • Smoke.

Symptoms

The general symptoms that commonly occur are:

  • Pain and discomfort over the infected breast. It often throbs and worsens when the head is tilted forward.
  • Pain when chewing

Nasal symptoms

Blocked nose –  Usually both sides of the nose feel blocked. The sense of smell can also be affected.

Runny Nose: If the discharge is green / yellow in color, it is more likely a germ (bacterial) infection in your sinuses. The green / yellow color is due to infected mucus and pus.

A runny nose can dry out if the sinus drainage channels become blocked with thick mucus. If this happens, the pain and tenderness over the infected breast may get worse.

Other symptoms

  • High temperature (fever):  This can develop in conjunction with a general malaise.
  • Headache.
  • Bad breath.
  • Toothache.
  • Tos.
  • A feeling of pressure or fullness in the ears.
  • Fatigue.

Symptoms in children

  • Irritability.
  • Ear discomfort
  • Ronquidos.
  • Breathing through the mouth.
  • Difficulty feeding.
  • Speak nasal.

How is acute sinusitis diagnosed?

The doctor can usually diagnose acute sinusitis by looking at common symptoms. It also checks the temperature or tenderness over the sinuses.

Also, examine the nose as the lining of the nose is often swollen in acute sinusitis.

Generally, comprehensive medical examinations or major tests are not needed to diagnose acute sinusitis.

Occasionally, blood tests, X-rays, or scans are recommended if the diagnosis is unclear.

Treatments

Antibiotics are usually not needed. Most cases of acute sinusitis are due to infection with a virus.

As with colds, the immune system normally clears the virus, and symptoms usually clear up within a couple of weeks.

Antibiotics do not kill viruses. Even if the infection is caused by bacteria, the immune system will usually clear it.

So, for most people with acute sinusitis, antibiotics are not needed. Antibiotics can also cause side effects.

Side effects can include diarrhea, nausea, vomiting, skin rash, and fungal infection. However, antibiotics are sometimes helpful.

Your doctor is unlikely to prescribe an antibiotic for a mild episode of acute sinusitis.

However, a course of antibiotics may be prescribed in some cases, for example:

  • If the symptoms are severe or if the patient is very ill.
  • If you have another disease, such as cystic fibrosis, heart problems, or a weakened immune system.
  • If symptoms do not resolve in seven days or get worse.

Treatment to relieve symptoms

Some treatments can help relieve symptoms while waiting for the immune system to clear the infection. These include the following:

  • Pain relievers like acetaminophen or ibuprofen will generally ease any pain. They also help reduce high temperatures.
  • Decongestant nasal sprays or drops can briefly relieve a blocked nose. However, it is not recommended to use them for more than 5-7 days at a time.
  • Staying hydrated can help, so drink plenty of drinks.
  • Placing hot water compresses on the sinuses can help relieve pain.
  • Saline nasal drops can help relieve congestion and blockage in the nose.
  • Steam inhalation is a traditional remedy, but is now rarely recommended. This is because there is little evidence that it helps.

A doctor should be consulted if symptoms become severe or do not improve within a week. The type of symptoms that should be reported to a doctor include:

  • Severe pain and / or swelling in the front of the head.
  • Swelling around the eye
  • Swelling of the face
  • Bloody discharge coming from the nose.
  • It is also advisable to see a doctor if there are recurrent outbreaks of sinusitis, as this may indicate an underlying problem.

Complications of acute sinusitis

Chronic sinusitis can sometimes develop from acute sinusitis. This is the most common complication.

Chronic sinusitis causes symptoms similar to acute sinusitis but lasts longer.

Other complications are rare. However, they can be serious. For example, the infection can spread from a breast to around an eye, to the bones, to the blood, or to the brain.

These serious complications are estimated to occur in about 1 in 10,000 cases of acute sinusitis.

They are more common with frontal sinus infection. Children are more prone to complications than adults.

Swelling or redness of an eyelid or cheek in a child with sinusitis should be urgently reported to a doctor.