Acute Bacterial Sinusitis
Acute Bacterial Sinusitis
What is sinusitis? — Sinusitis is a condition that can cause a stuffy nose, pain in the face, and discharge (mucus) from the nose. The sinuses are hollow areas in the bones of the face (figure 1). They have a thin lining that normally makes a small amount of mucus. When this lining gets irritated or infected, it swells and makes extra mucus. This causes symptoms.
Sinusitis can occur when a person gets sick with a cold. The germs causing the cold can also infect the sinuses. Many times, a person feels like his or her cold is getting better. But then he or she gets sinusitis and begins to feel sick again.
What are the symptoms of sinusitis? — Common symptoms of sinusitis include:
Stuffy or blocked nose
Thick white, yellow, or green discharge from the nose
Pain in the teeth
Pain or pressure in the face – This often feels worse when a person bends forward.
People with sinusitis can also have other symptoms that include:
Ear pressure or fullness
Most of the time, symptoms start to improve in 7 to 10 days.
Should I see a doctor or nurse? — See your doctor or nurse if your symptoms last more than 10 days, or if your symptoms get better at first but then get worse.
Sometimes, sinusitis can lead to serious problems. See your doctor or nurse right away (do not wait 10 days) if you have:
Fever higher than 102°F (38.9°C)
Sudden and severe pain in the face and head
Trouble seeing or seeing double
Trouble thinking clearly
Swelling or redness around one or both eyes
A stiff neck
Is there anything I can do on my own to feel better? — Yes. To reduce your symptoms, you can:
Take an over-the-counter pain reliever to reduce the pain
Rinse your nose and sinuses with salt water a few times a day – Ask your doctor or nurse about the best way to do this.
Your doctor might also prescribe a steroid nose spray to reduce the swelling in your nose. (Steroid nose sprays do not contain the same steroids that some athletes take illegally.)
How is sinusitis treated? — Most of the time, sinusitis does not need to be treated with antibiotic medicines. This is because most sinusitis is caused by viruses – not bacteria – and antibiotics do not kill viruses. Many people get over sinus infections without antibiotics.
Some people with sinusitis do need treatment with antibiotics. If your symptoms have not improved after 10 days, ask your doctor if you should take antibiotics. Your doctor might recommend that you wait 1 more week to see if your symptoms improve. But if you have symptoms such as a fever or a lot of pain, he or she might prescribe antibiotics. It is important to follow your doctor's instructions about taking your antibiotics.
What if my symptoms do not get better? — If your symptoms do not get better, talk with your doctor or nurse. He or she might order tests to figure out why you still have symptoms. These can include:
CT scan or other imaging tests – Imaging tests create pictures of the inside of the body.
A test to look inside the sinuses – For this test, a doctor puts a thin tube with a camera on the end into the nose and up into the sinuses.
Some people get a lot of sinus infections or have symptoms that last at least 3 months. These people can have a different type of sinusitis called "chronic sinusitis." Chronic sinusitis can be caused by different things. For example, some people have growths in their nose or sinuses that are called "polyps." Other people have allergies that cause their symptoms.
Chronic sinusitis can be treated in different ways. If you have chronic sinusitis, talk with your doctor about which treatments are right for you.
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 15535 Version 15.0
Release: 28.2.2 - C28.105
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