Sinus Infections

Sinus infections, medically termed sinusitis, are extremely common. About 90 percent of adults have experienced at least one bout of sinusitis during their lives, and every year, somewhere between 10 and 30 percent of people in the U.S. suffer from at least one sinus infection. It makes sense why sinusitis is so common, as the sinuses are one of the body’s most exposed systems. But even though the sinuses are configured to resist infection, it still happens. In a way, that’s a sign that the body is doing a good job of trapping bacterial and viral invaders before they have a chance to penetrate deeper and do serious damage.

That said, sinusitis can produce troubling complications, though this isn’t common. In most cases, a sinus infection is a significant annoyance, as the symptoms can knock the patient off their feet for a few days. In some patients, sinusitis is a chronic condition that represents a drain on quality of life. Fortunately, healthcare practitioners can offer treatment for sinus infections and help patients deal with chronic sinusitis problems.

What are the symptoms of sinus infections?

Sinusitis can be mistaken for a cold or another upper respiratory infection, but it is actually an infection of the sinus cavities. Those cavities exist on either side of the nose, around the bridge of the nose and behind the forehead, where the eyebrows come together.

Symptoms of sinusitis include:

  • Inflammation of the mucous membranes. This is something a healthcare practitioner will have to confirm during a physical examination.
  • Headache or other dull aching in the face. This pain may get worse when the patient lies down or bends over.
  • Nasal discharge that may be thick and colored. Green is the most common discharge color.

If sinusitis progresses, it may produce fever, ear pain or even threaten the eyes, so it is important to head it off if it does not improve within a few days.

What causes sinus infections and how are they classified?

Sinusitis is usually the result of a viral infection, though it can also be caused by bacteria, allergies or even air pollution. It’s possible that physical defects to the sinuses can also increase the likelihood of developing sinusitis, though the research isn’t well defined in this area.

Sinusitis can also be a secondary infection, meaning it itself is a complication arising from another condition. Periodontal infections, for example, often give rise to sinus infections, and the presence of a tooth infection is often a defining diagnostic characteristic of sinusitis.

Occasionally, sinus infections are due to abnormalities in the auditory tubes, and particularly the Eustachian tube. If the patient suffers from recurring ear infections, this can be a signifier of the sinusitis’ cause.

Healthcare practitioners classify sinusitis in patients in a couple ways. One is classified by where pain or pressure is felt, and the other depends on how long the infection has lasted, or how often it recurs. For the patient, it’s not particularly important where exactly in the sinuses the infection is occurring, as they are all treated the same. Maxillary infections, or tooth infections, are important to note, though, as they can point to an underlying dental problem.

However, for patients who feel like they can never escape their symptoms, a discussion with their healthcare practitioner is important. This is how healthcare practitioners classify sinus infections by their length and recurrence rate:

  1. Acute sinusitis – Acute sinusitis is an infection that typically lasts less than four weeks and can either be severe or not so severe.
  2. Subacute sinusitis – Subacute sinusitis is an infection that lasts between four and 12 weeks and is normally seen as a transition between an acute and chronic case.
  3. Chronic sinusitis – Chronic sinusitis is defined by a sinus infection that lasts more than 12 weeks.
  4. Recurrent acute sinusitis – When a patient experiences at least four instances of acute sinusitis over a 12 month period, they are diagnosed with recurrent sinusitis.

Recurrent or chronic sinusitis can have a major impact on a person’s wellbeing, so if frequent or long lasting sinus infections are present, address this with the healthcare practitioner. For example, healthcare practitioners often recommend CT scans for patients with chronic conditions, or a nasal endoscopy.

Healthcare practitioners verify the presence of a sinus infection with a simple examination, though an examination cannot tell the difference between a viral and bacterial infection. The only way to distinguish the two is to engage in watchful waiting. In other words, the healthcare practitioner monitors the patient to see if symptoms worsen or remain the same over a 10-day period. If they worsen, the infection is usually bacterial. If they remain the same, a viral infection is likely the cause.

Can sinus infections become serious?

The majority of sinus infections will resolve with rest, but severe complications are possible if the infection is not treated, especially in very young patients. Because the sinuses are located in close proximity to the eyes, throat and brain, the infection can quickly threaten other parts of the body if it spreads.

Cellulitis in or around the eye socket is among the complications of sinus infections, and can result in vision loss if not treated with haste. If not treated, abscesses may form, potentially extending the infection’s scope, length and potential for complications.

In rare cases, sinusitis migrates to the central nervous system, producing altered consciousness, visual disturbance, personality changes and life-threatening complications like meningitis. These are, again, rare but potential complications, and are more likely to occur if the sinus infection becomes chronic.

Can sinus infections be treated effectively?

The answer depends. Sinus infections caused by a virus will not respond to antibiotics and can only be resolved with time, rest and plenty of fluid intake. Symptoms can be alleviated by inhaling low temperature steam (like that produced by a shower) or with certain nasal sprays.

If the patient’s condition does not respond within 10 days, the sinus infection is probably the result of bacteria, which the healthcare practitioner can treat with antibiotics. When prescribing antibiotics, the healthcare practitioner will note the patient’s age. Older patients may receive a shorter run of antibiotics to prevent antibiotic-resistant bacteria from forming, while children may be given a longer run to ensure all bacteria is destroyed. In both cases, the antibiotic is normally efficacious.

If chronic or recurring sinusitis is the diagnosis, the healthcare practitioner may recommend more intensive treatment, including surgery. Surgical intervention is the last resort, but may be indicated if the patient has experienced complications from recurring or chronic infections. There are many approaches to sinus surgery, including older techniques for patients that cannot find relief through any other form of treatment.

Fortunately, it rarely comes to that, and sinus infections rarely represent more than a trip to bed and plenty of downtime. However, if symptoms are particularly troublesome or do not resolve within a few days, consult with your primary care healthcare practitioner to rule out potentially serious conditions.