Signs and symptoms

Signs and symptoms of acute sinusitis may include:

• Congestion that makes it difficult for you to breathe through your nose
  
  
• Yellow or greenish nasal discharge
  
  
• Pain, tenderness and swelling around your eyes, cheeks, nose or forehead
  
  
• Headache
  
  
• Fever and chills
  
  
• Reduced sense of smell or taste
  
  
• Cough
  
  
• Tooth pain
  
  
• Bad breath
  
  
• Fatigue
  
  
• Ear pain

If you've had three or more of these signs and symptoms for longer than a week, you may have sinusitis.

Mouth, jaw and face pain Bad breath Smell and taste disorders

Causes

A viral, bacterial or fungal infection of the upper respiratory tract — the air passages located in the head and neck — including viruses that cause the common cold, can lead to acute sinusitis. When an infection such as a cold inflames and swells mucous membranes in your nose, the swelled membranes can obstruct the sinus openings and keep mucus from draining. As this drainage becomes blocked, it creates an environment in which bacteria and viruses trapped in the sinuses can grow.

Conditions other than colds may cause you to develop sinus obstructions and a susceptibility to sinusitis. They include:

• Allergies. Inflammation that occurs with allergies may block your sinuses.
  
  
• Deviated nasal septum. In this condition, the wall between the nostrils (the nasal septum) is crooked. This may restrict or block sinus passages, creating an environment for infections.
  
  
• Nasal polyps. These growths of tissue may restrict the nasal passages, slowing drainage and allowing infections to grow.

The blockages associated with sinusitis can become worse if you smoke or are exposed to air pollution, both of which can cause further irritation or inflammation.

Allergy Center

When to seek medical advice

Start with self-care steps if you have only mild symptoms. Contact your doctor if your symptoms don't improve within a few days.

If you have any of the following symptoms, contact your doctor immediately:

• Fever greater than 100.5 F
  
  
• Pain, swelling or redness on your face or around your eyes
  
  
• Severe headache
  
  
• Confusion
  
  
• Stiff neck

Screening and diagnosis

Your doctor will evaluate your symptoms and may ask whether you've had a recent cold, whether you have allergies and whether you smoke. These factors may precipitate or contribute to acute sinusitis.

During a physical examination, your doctor may feel for tenderness in the area of the sinuses and examine your nasal passages looking for inflammation, secretions or deformities. Your doctor may use a thin tube with a light (endoscope) to look at your nasal passages. Visually inspecting your sinuses may allow your doctor to detect conditions, such as nasal polyps, that may trigger symptoms similar to sinusitis.

Complications

Sinusitis can aggravate the symptoms of asthma. See your doctor right away if you have asthma and develop symptoms of sinusitis. Effectively treating your sinusitis can reduce your asthma flare-ups.

Serious complications from sinusitis are rare, but can be life-threatening. If the infection spreads beyond your sinuses, you may develop:

• Meningitis. The infection may spread to the bones of your eyes or to the membranes that protect your brain (meninges), causing brain damage.
  
  
• Vision problems. You may experience reduced vision or even blindness if the infection spreads to your eye socket.
  
  
• Blood vessel complications. Infection that spreads to the veins around your sinuses can cause aneurysms and blood clots that interfere with the blood supply to your brain.

Asthma Center Meningitis

Treatment

Most people with acute sinusitis — 60 percent to 70 percent — get better without antibiotics. If you haven't had sinusitis before and your symptoms are mild, try using over-the-counter (OTC) decongestants and pain relievers. If your symptoms don't improve within 3 days, contact your doctor.

Your doctor may prescribe an antibiotic for 10 to 14 days. If your symptoms persist, you may need a longer course of treatment or a different type of antibiotic. Be sure to finish the entire course of the antibiotic prescription even if your symptoms disappear before all of the pills or capsules are gone. This will ensure that you've destroyed all of the bacteria and that your symptoms won't recur.

Your doctor may also recommend:

• Treating an underlying allergic condition that contributes to sinusitis
  
  
• Using prescription decongestants, nasal corticosteroid spray or oral corticosteroid pills to relieve stuffiness
  
  
• Using over-the-counter medications that contain mucus-thinning agents (mucolytics) such as guaifenesin (Mucinex, Robitussin)
  
  
• Taking over-the-counter pain relievers

OTC pain relievers: Which ones are right for you? Corticosteroids: Inhaled, intranasal drugs for asthma and allergies Allergy shots

Prevention

Take these steps to reduce your risk of sinusitis:

• Reduce your risk of upper respiratory infections. Minimize close contact with people who have colds and wash your hands frequently with soap and water.
  
  
• Don't smoke. Tobacco smoke can cause irritation and inflammation of the lining of the sinuses and nose. Inflammation can result in blocked nasal passages.
  
  
• Avoid polluted air. Contaminants in the air, whether indoors or outdoors, can irritate and inflame your lungs and nasal passages.

Hand washing: The simplest way to avoid infection Stop Smoking Program

Self-care

If you do get sinusitis, these self-help steps can help relieve symptoms:

• Steam your sinuses. By inhaling steam several times a day, you'll stimulate drainage from the sinuses. Lean over a bowl of hot water for a few minutes with a towel draped over your head and the bowl to keep the steam directed toward your face.
  
  
• Apply warm compresses. Place warm, damp cloth compresses around your nose, cheeks and eyes to ease facial pain.
  
  
• Drink fluids. Dilute secretions and promote drainage by consuming at least six 8-ounce glasses of fluids daily.
  
  
• Take an over-the-counter (OTC) decongestant. Nasal spray decongestants such as oxymetazoline (Afrin, Nostrilla) or phenylephrine (Neo-Synephrine, Vicks Sinex), can relieve nasal obstructions and increase sinus drainage. However, don't take OTC decongestants for more than a few days without your doctor's recommendation. Over time, these products may make your symptoms of nasal congestion worse.
  
  
• Don't drink alcohol. Drinking alcohol can worsen the swelling of the lining of the sinuses and nose.

— April 23, 2003 —