Viral Sinusitis And Bacterial Sinusitis
Viral sinusitis is the most common type of sinusitis. It is usually caused by the same viruses that cause the common cold, and typically lasts for between seven and ten days. If the condition lasts longer than ten days, or there is a worsening of symptoms after five to seven days, the sinusitis is more likely caused by bacteria than a virus.
What Is Sinus Infection
Medically known as rhinosinusitis, Sinus infection or Sinusitis is an inflammation or swelling of the tissue lining the sinuses. Healthy sinuses are filled with air. But when they become blocked and filled with fluid, germs can grow and cause an infection. It occurs when your nasal cavities become infected, swollen, and inflamed. Sinusitis is usually caused by a virus and often persists even after other upper respiratory symptoms are gone. In some cases, bacteria, or rarely fungus, may cause a sinus infection.
Symptoms Of A Sinus Infection
The primary symptoms of a sinus infection could be initially mistaken for the common cold, including a stuffed up nose and a decrease in your senses of taste and smell. However, other symptoms such as pain or pressure around the sinuses, achy teeth, and thick yellow or green mucus indicate that your cold has progressed into a sinus infection. Additionally, cold symptoms that last longer than a week may be a sign you have sinusitis. Other symptoms associated with a sinus infection include:
- Phlegm-producing cough or a cough that gets worse at night
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Fungal Ball Sinus Infection
A fungal ball sinus infection, or mycetoma, is a condition in which fungal hyphae accumulate in the sinuses and form fungal balls. If left untreated, these balls can grow bigger and block the sinuses, causing facial pain, swelling, and tenderness. Fungal balls can also trap bacteria, which can lead to a secondary bacterial infection.
What Is Chronic Sinus Infection
Chronic sinusitis is a long-standing inflammation of your sinuses that lasts for 12 weeks or longer at a time. Sinusitis is also known as rhinosinusitis . So, we use the two terms interchangeably. When inflamed, nasal passages and sinuses become swollen and blocked. Chronic sinusitis interferes with the normal drainage of the mucus. Too much mucus builds up in your nose and sinuses, making them stuffy.
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What Are The Signs And Symptoms Of Chronic Sinus Infection
Chronic sinusitis emerges more insidiously than acute sinusitis. At times, however, the symptoms start suddenly and may resemble that of the common cold or acute sinusitis that just wont go away.
Chronic sinusitis is most likely if you have two or more of the following symptoms:
- Nasal congestion or stuffy nose
- Mucus and pus-like discharge
- Postnasal drip
- Facial pain, pressure around your eyes and nose, or fullness
- Partial or complete loss of your sense of smell
Chronic cough, sore throat, and fatigue may also be seen in a chronic sinus infection. That said, these symptoms are not required for the diagnosis of chronic rhinosinusitis.
What To Do For Chronic Sinusitis
If youre suffering from chronic sinusitis or you are getting frequent sinus infections you should see your doctor, says Dr. Sindwani.
Your doctor will swab your nose to collect mucus. Culturing it in a laboratory will reveal which type of bacteria is causing the infection so the right antibiotic can be prescribed.
Treat early sinus infection symptoms with rest, hydration and over-the-counter sprays and decongestants. But dont look for an antibiotic unless your illness extends beyond a week, he says. Then check in with your doctor for a prescription and let him or her know if your condition worsens.
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How To Treat A Sinus Infection At Home
You can effectively treat sinus infections at home with over-the-counter medicines or one or more home remedies.
Dethlefs recommends, Drink plenty of water, use Vicks vapor rub on chest and bottoms of feet, rest and sleep and humidifier. One thing I like to do when my family is sick is boil water on the stove and melt Vicks vapor rub in it. Then pour solution in ice cube trays and freeze. Add 1-2 ice cubs to bottom of shower.
OTC medicines that may improve symptoms of a sinus infection include:
- Nasal decongestant sprays help reduce swelling in the nasal passages to promote drainage flow from the sinuses. This sinus infection treatment should only be used for three to four days to reduce the risk of rebound congestion.
- Nasal corticosteroid sprays help reduce swelling and inflammation in the nasal passages without causing rebound congestion.
- Antihistamines remain particularly helpful for those whose nasal passages become inflamed and swollen due to seasonal allergies.
- Nasal saline washes and rinses help clear mucus from the nasal passages to promote easier breathing.
Your doctor may also prescribe antibiotics if OTC medicines fail to relieve your symptoms within seven to 10 days. Antibiotics are usually only prescribed as a last-resort treatment for sinus infections due to the risk of overuse, which may lead to other difficult-to-treat infections.
Home remedies for sinus infection include:
Antibiotic Treatment For Bacterial Sinusitis
Antibiotic treatment is usually only needed if the infection does not improve within 7-10 days, the person has another medical condition which may affect recovery, or if:
- Severe pain is present
- Swelling at the front of the head, cheeks or around the eyes occurs
- Nasal discharge contains blood
- High fever is present
These are indications that the bacterial infection is severe. Antibiotic treatment is usually prescribed for about 10 days, but shorter courses may be as effective, depending on the bacteria involved. The choice of which antibiotic to use will be based on which bacteria the treating physician thinks are likely to be involved in the infection.
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When Do We Need Antibiotics For Sinus Infection
Antibiotics are not needed for many sinus infections, but your doctor can decide if you need an antibiotic. You doctor may recommend antibiotics if:
Most sinus infections usually get better on their own without antibiotics. When antibiotics arent needed, they wont help you, and their side effects could still cause harm. Side effects can range from minor issues, like a rash, to very serious health problems, such as antibiotic-resistant infections and C. diff infection, which causes diarrhea that can lead to severe colon damage and death.
Middle And External Ear Infections
A middle ear infection can cause ear congestion, as well as dizziness, ear pain, and occasionally fluid drainage. Theyre usually caused by colds or other respiratory problems that travel to the middle ear through the Eustachian tube.
External ear infections, also known as swimmers ear, are usually caused by water that remains in your ear after swimming or bathing, providing an ideal breeding ground for bacteria. You may experience pain, itching, redness, and clear fluid drainage or a discharge of pus.
Ear infections often resolve without treatment. Over-the-counter ear drops and pain medication can help relieve your symptoms. If your symptoms are severe or last more than two days, your doctor may prescribe antibiotics.
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Symptoms Of Bacterial Sinusitis
Symptoms of bacterial sinusitis include:
- Pressure or pain around the nose, in the forehead, in the cheeks or around the eyes. The pain often gets worse if the affected person bends forward.
- Discolored, thick nasal discharge
- Painful teeth
- Painful chewing
Good to know: Bacterial sinusitis can follow a cold or the flu, and often the symptoms occur just when it seems as if the initial infection is clearing up. In this situation it is common to start to feel better, and then to feel worse as the subsequent bacterial sinusitis develops.
If you are concerned that you or a loved one may have bacterial sinusitis, you can do a free symptom assessment using the Ada app at any time.
Recommendations For Antimicrobial Therapy
Ahovuo-Saloranta et al, in a 2008 Cochrane Review meta-analysis of 57 studies, concluded that antibiotics yield a small treatment effect in a primary care setting in patients with uncomplicated sinusitis whose symptoms have lasted more than 7 days. However, another meta-analysis found no treatment effect of antibiotics, even in patients whose symptoms had persisted for more than 10 days.
In cases of suspected or documented bacterial sinusitis, the second principle of treatment is to provide adequate systemic treatment of the likely bacterial pathogens . The physician should be aware of the probability of bacterial resistance within their community. Reports range from approximately 33-44% of H influenzae and almost all of M catarrhalis strains have beta-lactamasemediated resistance to penicillin-based antimicrobials in children.
Risk factors for pneumococcal and H. influenzae resistance are:
- Residing in a region with rates of penicillin-nonsusceptible Streptococcus pneumoniae > 10 %.
- Antibiotic use by the patient or member of their household in the last 6 weeks.
- Attendance in a day care center.
- Age 65 years
Blackwell DL, Lucas JW, Clarke TC. Summary health statistics for U.S. adults: National Health Interview Survey, 2012. Vital Health Stat 10. 2014, february. 1-161. .
Lanza DC, Kennedy DW. Adult rhinosinusitis defined. Otolaryngol Head Neck Surg. 1997 Sep. 117:S1-7. .
Ah-See K. Sinusitis . Clin Evid . 2008 Mar 10. 2008:.
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Pain Or Pressure In Your Sinuses
Facial pain is a common symptom of sinusitis. You have several different sinuses above and below your eyes, as well as behind your nose. Any of these air-filled cavities can hurt when you have a sinus infection.
Inflammation and swelling can cause your sinuses to ache with dull pressure. This is because inflammation may alter the typical path of mucus from the nose to the back of the throat.
You may feel pain in:
- your forehead
- on either side of your nose
- in your upper jaws and teeth
- between your eyes
This may lead to a headache. Headaches caused by sinus infections can occur where the sinuses are or in other places.
Symptoms Of Bacterial Sinus Infection
As per the guidelines, a sinus infection is more likely to be bacterial than viral if any of the following conditions are present.
- No clinical improvement occurs in the symptoms even after the passage of at least 10 days.
- The severity of the symptoms is quite high, including facial pain, nasal discharge and a fever in excess of 102°F which remains for at least 4 days on the trot at the start of the illness.
- Worsening of the symptoms is characterized by the development of a new headache or fever or increase in the amount of nasal discharge, usually after a viral infection of the upper respiratory tract that has remained for 6 days and had seemed to improve initially.
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Interactions Of Amoxicillin For Sinusitis
As the Amoxicillin 500 mg Tablet is allopathic medicine, it can easily react with other medicines that you are taking. The other medicines, when combined with Amoxicillin 500 mg tablet, can worsen the side effects of Amoxicillin 500 mg Tablet.
Not only the side effects but any underlying health issue can also aggravate if this medicine is taken without the doctors approval.
Medicines that can interfere with Amoxicillin 500 mg Tablet and can cause moderate or serious side effects are-
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Treatments For Sinus Infections Other Than Antibiotics
#1: Saline Nasal Wash
Saline nasal wash can be a great way to thin out the mucous in the sinuses enough to clear out the blockage. I recommend starting this early on in the course of the illness to prevent the infection from worsening.
You can even make this at home using 2 cups of water and a 1/2 teaspoon of salt. I would add a 1/2 to 1 teaspoon of baking soda to prevent burning that can occur with use. There are also plenty of over the counter saline nasal sprays that you can purchase. You can use this 4-6 times per day.
Vaporizers are great because they can also thin out the mucous and make you feel a lot better. An easy home remedy, steam is probably the best way to use this treatment. Beware if you are an asthmatic as the steam could cause worsening of the asthma symptoms.
#3: Steroid Nasal Spray
Steroid nasal sprays such as Flonase have been my go to remedy recently and the great news is that they are now over the counter. The general recommendation is to use 1-2 sprays per nostril daily.
But I have found great relief using 2 sprays in each nostril twice daily. At these higher doses it is important to remember that you should use this short term, no more than 5-7 days.
These medications can significantly reduce inflammation allowing the congestion blockage to clear and significantly alleviate symptoms.
Guaifenesin such as Mucinex can certainly break up the mucous, allowing the congestion to clear more quickly.
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How To Treat Sinus Infections Without Antibiotics
While sinus infections caused by viruses, allergies, or other non-bacterial factors may not require antibiotics, they still cause the same symptoms which make you feel sick.
Symptoms of a sinus infection include:
- Nasal congestion
- Pain or tenderness around the eyes, cheeks, or forehead
- Thick nasal or post-nasal drainage
Taking steps to alleviate your sinusitis symptoms is often the best treatment to lessen your discomfort.
Sinus infection treatment options include:
- Drink plenty of fluids
- Rest, especially the first few days, to help your body fight the infection
- Moisturize the air with a cool-mist vaporizer
- Elevate your head while sleeping to decrease post-nasal drip
- Take warm showers or baths, as steam can soothe your sore throat and loosen mucus
- Gargle with warm salt water for a sore throat
- Use saline nasal spray or nasal irrigation kit to alleviate congestion
- Use over-the-counter treatments, such as nasal drops and sprays or pseudoephedrine pills, as your doctor recommends them
What Not to Do for a Sinus Infection
You should always follow your doctors instructions when you are diagnosed with a sinus infection.
- Ask for antibiotics if your doctor feels they are unnecessary
- Take antibiotics that are prescribed for someone else
- Skip doses of your antibiotics or stop taking your antibiotics early when your doctor prescribes them
- Save antibiotics for the next time you get sick
Ways To Recognize Serious Signs Of Sinus Infections
The length of the infection is an important determinant of the seriousness of the infection.
I usually consider most infections less than 3 weeks to be viral or inflammation related to congestion. At this point, the best treatment is usually medications that decrease the congestion and inflammation. This in turn will alleviate the symptoms and ultimately cure the illness.
When the illness continues beyond 3 weeks, bacterial infection can begin to develop. Though antibiotics can be considered at this point, other treatments may still be the best answer if they have not yet been given a try.
#2: Mucous Color
I will dispel a myth right here and now. Yellowish/greenish mucous does not necessarily mean the infection is bacterial.
Viruses can cause the same color mucous. The reason for the mucous is generally not the actual bacteria or virus, but the bodys immune response to the intruder.
So dont worry just because you see a colored mucous when you blow your nose. This will also improve as the infection abates.
#3: Sinus Pain
Sinus pain can occur anytime throughout a sinus infection. This is normal and means there is inflammation in the sinuses, as we discussed previously.
However, severe pain, redness over the skin, hardened skin over the sinuses, or even a severe headache are not generally normal and can indicate a bacterial infection.
A fever can be caused by both viruses and bacteria. So how do you differentiate between the two?
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Check If You Have Sinusitis
Symptoms of sinusitis include:
- pain, swelling and tenderness around your cheeks, eyes or forehead
- a blocked nose
- a reduced sense of smell
- green or yellow mucus from your nose
- a sinus headache
- bad breath
Signs of sinusitis in young children may also include irritability, difficulty feeding, and breathing through their mouth.
The sinuses are small, empty spaces behind your cheekbones and forehead that connect to the inside of the nose.
Sinusitis causes the lining of the sinuses to swell up.
This stops mucus draining into your nose and throat properly, making you feel blocked up.
Surgical Treatment For Bacterial Sinusitis
Surgery is not usually needed for acute bacterial sinusitis. It is only necessary in some cases of chronic sinusitis that do not respond to other forms of treatment. Endoscopic treatment, where a small camera-equipped probe is used to guide and perform the procedure, is one option. In this surgery, the endoscope is used to widen the natural drainage pathways in the sinuses and nose, which improves mucus drainage and cuts down on congestion and the chance of infection.
Rarely, acute bacterial sinusitis may cause an abscess to form near the eye or the brain. In these cases, surgical treatment will be needed to drain the abscess.
Good to know: Complications from bacterial sinusitis are rare, affecting only about one in every ten thousand people with the disorder. However, they are more common among children than adults, so caregivers of children with suspected bacterial sinusitis should exercise caution and be alert for worsening symptoms, swelling or redness of any area of the childs face.
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