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Sinus Infection – Sinusitis

Contrary to common belief and practice, not all sinuses infections are caused by bacteria.  Even infections caused by bacteria usually do not require antibiotics (except in severe or prolonged cases).  Pain relievers, fluids and decongestants are normally all that is required.  Bacterial infection of the sinuses (spaces in the bones near the nose, cheeks and forehead) occur in only 2% of people following a viral upper respiratory infection. The lining inside the spaces swells and blocks the normal drainage.  The drainage becomes trapped inside the sinus along with the mucous draining from the nose and can become infected.  If the infection is persistent or lasts longer than 30 days, it is said to be chronic sinusitis.

Symptoms may include:

  • Green-yellow nasal drainage, usually thick
  • Increased pressure in the head
  • Eye pain and headache
  • Fever and chills
  • Nausea
  • Disturbance in sleep

What your doctor can do:

  • Diagnose sinusitis by asking about your symptoms and performing a physical exam, including an exam of your throat, lungs, and sinuses
  • Order blood tests to check the white blood count (WBC).  An increase in the WBC usually indicates an infection
  • Prescribe a pain reliever until your body’s natural defenses defeat the infection (usually within 10-14 days)
  • Prescribe antibiotics when symptoms persist longer than 14 days or are particularly severe.  Antibiotics will not work on viral infections.

What you can do:

  • If the sinusitis is caused by allergies, try to avoid the allergen.  A nasal steroid can help decrease the inflammation.  Antihistamines are drying and should be avoided.
  • If an antibiotic is prescribed, take it until completed, even after feeling better.
  • Use a cool mist humidifier to thin secretions.  This helps the drainage
  • Drink plenty of clear fluids, especially water
  • Use a nasal aspirator (to clear the nasal discharge) in young children
  • Use a decongestant only when you have an upper respiratory tract infection or cold.  Nasal decongestants can become addictive and cause more problems if overused
  • Rest
  • Try exercise.  For some people this helps the condition, for others it worsens it.
  • Some people experience sudden drainage from a blocked sinus and relief by irrigating with saline (salt) solution.

Contact your doctor if you still have facial pain and sinus pressure after 10 days, persistent fever after 1 week, or are feeling worse (such as development of spiking fever and chills or cough with wheezing).

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