Acute sinusitis

Overview

Acute sinusitis causes the spaces inside the nose, known as sinuses, to become inflamed and swollen. Acute sinusitis makes it hard for the sinuses to drain. Mucus builds up.

Acute sinusitis can make it hard to breathe through the nose. The area around the eyes and the face might feel swollen. There might be throbbing face pain or a headache.

The common cold is the usual cause of acute sinusitis. Most often, the condition clears up within a week to 10 days unless there's also an infection caused by bacteria, called a bacterial infection. Home remedies might be all that's needed to treat acute sinusitis. Sinusitis that lasts more than 12 weeks even with medical treatment is called chronic sinusitis.

Symptoms

Acute sinusitis symptoms often include:

• Thick, yellow or greenish mucus from the nose, known as a runny nose, or down the back of the throat, known as postnasal drip.
• Blocked or stuffy nose, known as congestion. This makes it hard to breathe through the nose.
• Pain, tenderness, swelling and pressure around the eyes, cheeks, nose or forehead that gets worse when bending over.

Other signs and symptoms include:

• Ear pressure.
• Headache.
• Aching in the teeth.
• Changed sense of smell.
• Cough.
• Bad breath.
• Tiredness.
• Fever.

When to see a doctor

Most people with acute sinusitis don't need to see a health care provider.

Contact your health care provider if you have any of the following:

• Symptoms that last more than a week.
• Symptoms that get worse after seeming to get better.
• A fever that lasts.
• A history of repeated or chronic sinusitis.

See a health care provider immediately if you have symptoms that might mean a serious infection:

• Pain, swelling or redness around the eyes.
• High fever.
• Confusion.
• Double vision or other vision changes.
• Stiff neck.

Causes

Acute sinusitis is an infection caused by a virus. The common cold is most often the cause. Sometimes, sinuses that are blocked for a time might get a bacterial infection.

Risk factors

The following can raise the risk of getting sinusitis:

• Hay fever or another allergy that affects the sinuses.
• A common cold that affects the sinuses.
• A problem inside the nose, such as a deviated nasal septum, nasal polyps or tumors.
• A medical condition such as cystic fibrosis or an immune system disorder such as HIV/AIDS.
• Being around smoke, either from smoking or being around others who smoke, known as secondhand smoke.

Complications

Acute sinusitis doesn't often cause complications. Complications that might happen include:

• Chronic sinusitis. Acute sinusitis can be a flare-up of a long-term problem known as chronic sinusitis. Chronic sinusitis lasts longer than 12 weeks.
• Meningitis. This infection affects the membranes and fluid around the brain and spinal cord.
• Other infections. It's not common. But an infection can spread to the bones, known as osteomyelitis, or to skin, known as cellulitis.
• Vision problems. If the infection spreads to the eye socket, it can reduce vision or cause blindness.

Prevention

Take these steps to help lower your risk of getting acute sinusitis:

• Stay well. Try to stay away from people who have colds or other infections. Wash your hands often with soap and water, such as before meals.
• Manage allergies. Work with your health care provider to keep symptoms under control.
• Avoid cigarette smoke and polluted air. Tobacco smoke and other pollutants can irritate lungs and inside the nose, known as nasal passages.
• Use a machine that adds moisture to the air, known as a humidifier. If the air in your home is dry, adding moisture to the air may help prevent sinusitis. Be sure the humidifier stays clean and free of mold with regular, complete cleaning.

Diagnosis

A health care provider might ask about symptoms and do an exam. The exam might include feeling for tenderness in the nose and face and looking inside the nose.

Other ways to diagnose acute sinusitis and rule out other conditions include:

• Nasal endoscopy. A health care provider inserts a thin, flexible tube, known as an endoscope, into the nose. A light on the tube allows the provider to see inside the sinuses.
• Imaging studies. A CT scan can show details of the sinuses and nasal area. It's not usually used for simple acute sinusitis. But imaging studies might help rule out other causes.
• Nasal and sinus samples. Lab tests aren't often used to diagnose acute sinusitis. But if the condition doesn't get better with treatment or gets worse, tissue samples from the nose or sinuses might help find the cause.

Treatment

Most cases of acute sinusitis get better on their own. Self-care is usually all that's needed to ease symptoms.

Treatments to ease symptoms

The following might help ease sinusitis symptoms:

• Saline nasal spray. Salt water sprayed into the nose many times a day rinses the inside of the nose.
• Nasal corticosteroids. These nasal sprays help prevent and treat swelling. Examples include fluticasone (Flonase Allergy Relief, Flonase Sensimist Allergy Relief, others), budesonide (Rhinocort Allergy), mometasone and beclomethasone (Beconase AQ, Qnasl, others).
• Decongestants. These medicines are available with and without a prescription. They come in liquids, tablets and nasal sprays. Use nasal decongestants for only a few days because they may cause worse stuffiness, known as rebound congestion.
• Allergy medicines. For sinusitis caused by allergies, using allergy medicines might lessen allergy symptoms.

• Pain relievers. Try acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others) or aspirin available without a prescription.

  Use caution when giving aspirin to children or teenagers. Though aspirin is approved for use in children older than 3, children and teenagers recovering from chickenpox or flu-like symptoms should never take aspirin. This is because aspirin has been linked to Reye's syndrome, a rare but potentially life-threatening condition, in such children.

Antibiotics

Antibiotics don't treat viruses, which are the usual cause of acute sinusitis. Even if bacteria caused the acute sinusitis, called a bacterial infection, it might clear up on its own. So a health care provider might wait and see if the acute sinusitis gets worse before prescribing antibiotics.

But, if you have severe, worsening or long-lasting symptoms, your symptoms might need to be treated with antibiotics. Always take the whole course of antibiotics even after symptoms get better. Stopping antibiotics early might cause symptoms to come back.

Immunotherapy

For sinusitis caused or made worse by allergies, allergy shots might help. This is known as immunotherapy.

Lifestyle and home remedies

These steps can help relieve sinusitis symptoms:

• Rest. Rest helps the body fight infection and speed recovery.
• Drink fluids. Keep drinking plenty of fluids.
• Use a warm compress. A warm compress on the nose and forehead might help lessen pressure in the sinuses.
• Keep sinuses moist. Breathing in the steam from a bowl of hot water with a towel over the head might help. Or take a hot shower, breathing in the warm, moist air. This will help ease pain and help mucus drain.
• Rinse the inside of the nose. Use a specially designed squeeze bottle (Sinus Rinse, others) or neti pot. This home remedy, called nasal lavage, can help clear sinuses.

Alternative medicine

No alternative therapies have been proved to ease the symptoms of acute sinusitis. Products that have certain herbs in them might be of some help. These therapies have cowslip, gentian root, elderflower, verbena and sorrel in them.

Check with a health care provider before taking herbal or dietary supplements. Be sure they're safe and that they won't get in the way of medicines you take.

Preparing for an appointment

Here's information to help you get ready for your appointment.

What you can do

Make a list of:

• Your symptoms, including any that seem unrelated to the reason for your appointment, and when they began.
• Key personal information, including whether you have allergies or asthma, and family medical history.
• All medicines, vitamins or other supplements you take, including doses.
• Questions to ask your health care provider.

For acute sinusitis, questions to ask your provider include:

• What's likely causing my symptoms?
• What are other possible causes for my symptoms?
• What tests do I need?
• Is my condition likely to go away or be long lasting?
• What's the best course of action?
• I have other health conditions. How can I best manage them together?
• Are there brochures or other printed material I can have? What websites do you suggest?

Be sure to ask all the questions you have.

What to expect from your doctor

Your care provider is likely to ask you questions, such as:

• Do you have symptoms all the time or once in a while?
• How bad are your symptoms?
• What, if anything, seems to make your symptoms better?
• What, if anything, seems to make your symptoms worse?
• Do you smoke or are you around smoke or other pollutants?