Sinusitis

Sinus Infection

What is Sinusitis?

Sinusitis is an infection and inflammation of the sinuses in the facial region. Infection usually occurs after a cold or hay fever that caused swelling and blockage of the openings that drain the sinuses; bacteria can then multiply and cause infection. But, only one out of 200 people with a common cold progress to develop sinusitis. An abscess of an upper tooth can also occasionally result in sinusitis. Changes in atmospheric pressure, such as are experienced during airplane flights, can increase the risk of developing sinusitis. Also at increased risk are those who have experienced irritation of the sinuses from chemical fumes such as chlorine or ammonia.

How is it diagnosed?

Sinus Infection signs and symptoms

Sinusitis is diagnosed mainly by the symptoms reported by the individual. Typical symptoms include a thick discharge from the nose, ache in an upper tooth, poor response to nasal decongestants, history of cold or allergic rhinitis, headache, or facial pain. The headache and facial pain may be located over the infected sinus.

Physical exam may show tenderness over the affected sinus. A strong light can be directed over the sinuses to observe if there is fluid in them (transillumination of the sinuses).

Tests Sinus x-rays or CT scan may be needed. A sample of fluid from the sinuses might be drawn for bacterial culture and microscopic examination.

How is Sinusitis treated?

Once a diagnosis of sinusitis is made, antibiotic therapy is begun for at least ten to fourteen days. Improvement in symptoms can often be seen within two days of the start of treatment. However, if all symptoms have not resolved within two weeks, the individual should be reevaluated. Supportive treatment includes humidified air, decongestants to reduce swelling and promote drainage of the sinuses, and antihistamines if the nasal congestion is partially due to allergies. If sinusitis is unresponsive to antibiotic therapy, surgery to drain the sinus may be needed.

Medications

Information Brand Generic Label Rating
Co-trimoxazole Bactrim Co-trimoxazole Off-Label
http://www.nmihi.com/c/ciprofloxacin.html Cipro Ciprofloxacin On-Label
http://www.nmihi.com/a/amoxicillin.html Amoxil Amoxicillin On-Label
http://www.nmihi.com/a/azithromycin.html Zithromax Azithromycin On-Label
Principen Principen Ampicillin On-Label
Augmentin Augmentin Amoxicillin/Clavulanate On-Label
Motrin Motrin Ibuprofen Off-Label

Biaxin (Clarithromycin), Flonase (Fluticasone)

What might complicate it?

The infection may not respond to antibiotic therapy, especially if the openings to the sinuses remain blocked. The persistence of bacteria in the sinuses can lead to infection of the bone (osteomyelitis), soft tissue of the face (cellulitis), the brain, or its covering membrane (meningitis). Spread of infection to the eyes, mouth, and brain occurs more often in individuals with depressed immunity from AIDS or chemotherapy. Individuals who experience recurrent and prolonged sinus infections may require surgery to permanently improve sinus drainage.

Predicted outcome

Individuals with uncomplicated sinusitis can expect a full recovery and return to work.

Alternatives

The symptoms of sinusitis can be mimicked by the common cold, allergic rhinitis, and impacted or infected teeth. A tumor of the sinus is a less likely possibility.

Appropriate specialists

Otolaryngologist and allergist.

Notify your physician if

  • You or a family member has symptoms of sinusitis.
  • The following occur during treatment: Fever; bleeding from the nose; severe headache. Swelling of the face (forehead, eyes, side of the nose or cheek).

Last updated 15 December 2011


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