Sinusitis (Rhinosinusitis or Sinus Infection)
Sinusitis is a term meaning inflammation of the sinuses. Patients with environmental allergies can be at greater risk for sinusitis as they already have some inflammation present in their nasal passages. This baseline inflammation occurs due to a reaction to the environmental allergens around them.
When sinusitis has a duration of 4 weeks or less it is considered “acute” sinusitis. Sometimes relapses of symptoms or inflammation can occur, deeming the condition “recurrent.” When symptoms last longer than 12 weeks, the condition is defined as “chronic” sinusitis.
Acute sinusitis is often due to a viral infection and usually resolves in 7-10 days with supportive symptom management (saline sinus rinses, decongestants, nasal sprays) and the body’s natural ability to fight off illness. If symptoms last longer than 10 days, there is more concern for a bacterial infection and an antibiotic may be prescribed. Interestingly, many cases of bacterial sinusitis may resolve without the use of antibiotics and complications rarely develop.
If your medical provider prescribes antibiotics and symptoms aren’t improving, follow up is indicated. Other serious symptoms that would require follow up include: fevers >102 F that persist longer than 3-4 days, swelling or redness around the eyelids, vision changes, facial drooping or facial muscle weakness, confusion, headache, or inability to move the head/neck.
Chronic sinusitis can develop after an upper respiratory infection, an acute sinusitis that fails to resolve, or slowly over months/years until it becomes a problem. Signs in adults can include: facial pain/pressure, decreased sense of smell, discolored anterior or posterior nasal mucous, nasal stuffiness or congestion. A persistent cough may also occur (especially in children).
Treatment for chronic sinusitis generally includes nasal washes, nasal steroid and possibly oral steroids and/or an extended course of antibiotics. In some cases, sinus surgery may also be needed.
Because chronic sinusitis is a complex disorder of inflammation in the sinuses, it can take a while to treat. If the chronic sinusitis does not improve, evaluation by an Ear, Nose and Throat specialist may be needed to evaluate for nasal polyps, blocked drainage pathways or other problems that predispose to chronic sinusitis.