What is a Sinus Infection?
A sinus infection (sinusitis) is generally caused by a virus, or occasionally bacteria, which results in inflammation of the sinuses. It can sometimes be the result of an allergy.
This condition affects up to 31 million people in the US. Over one billion dollars is spent annually on over the counter treatments for it. It also accounts for 16 million visits to doctors, and a further 150 million dollars spent on prescriptions medications. (1)
About 90 percent of cases are caused by viral infections and the remaining 10 percent by bacteria. (2)
The sinuses are cavities filled with air, situated behind the forehead and in the bony structure of the cheeks. They are also located on each side of the nose and in front of the brain directly behind the nose.
The sinuses are lined with mucus which traps germs, dust and other particles found in the air we breathe. The mucus drains either into the nasal passages or down the back of the throat. (3)
When the sinuses are infected they become inflamed and the normal flow of mucus is interrupted. They become blocked and fill with fluid.
Some genetic defects can render people more susceptible to this condition. They include deformity of the bones which separate the nasal passages, nasal growths (polyps) and narrow sinus openings. (4)
There are also other conditions that can predispose people to sinus infections. These include infections of the upper respiratory tract, a weakened immune system and allergies.
Risk factors affecting children include the use of pacifiers, drinking bottles while lying down, secondhand smoke and attending daycare. (5)
The symptoms of a sinus infection include:
When the sinuses are inflamed they are unable to drain efficiently. The nasal passages can become congested or blocked. This can make it difficult to breathe through the nose. (6)
Discolored Nasal Discharge
Mucus which drains from the nose is normally clear. When the sinuses are infected it can be seen as green or yellowish in color. (7)
Decreased Sense of Smell and Taste
Inflammation in the sinuses can lead to an impaired sense of smell (hyposmia) or the inability to smell anything (anosmia).
The lack of smell can also interfere with the ability to taste things. (8)
An uncomfortable feeling of pressure might be felt behind the brow bone, in the cheeks or behind the nose.
Headaches might also be experienced, especially in the area around and above the eyes. (9)
Fatigue, a feeling of extreme tiredness and lethargy, might accompany the other symptoms of a sinus infection. (10)
Bad Breath (Halitosis)
Upper respiratory conditions, including sinusitis, can lead to a person having bad breath. (11)
Fever is defined as having a temperature which is higher than normal. This can sometimes happen when the sinuses are infected. (12)
Pain in the teeth and in the upper jaw might be felt when sinuses are inflamed. (13)
A sinus infection can cause mucous to run or drip down the back of the throat from the nose. Termed post nasal drip, this can make people cough. (14)
An infection of the sinuses can often affect nearby areas, including the throat. The result is a sore throat. (15)
Pain When Bending Forwards
Pain in the nasal or head areas when stooping or bending forwards might be felt when a sinus infection is present. (16)
A sinus infection might be confused with rhinitis, a condition that only affects the nasal passages. Allergens and pollutants are usually associated with rhinitis, and some symptoms present the same as for a sinus infection. (17)
Sinus infections are classed as acute, subacute or chronic depending on how long they last.
Acute Sinus Infection
This stage involves inflammation of the nose and sinuses, accompanied by two of the following symptoms. These include congestion of the nose, nasal discharge, facial pain or pressure and loss of smell. Further symptoms are toothache, fever, fatigue and pain when stooping.
These symptoms will last for less than four weeks and usually resolve within 10 to 14 days.
Subacute Sinus Infection
In this stage the symptoms listed above will last for a period between four and six weeks
Chronic Sinus Infection
This is defined as congestion or blockage of the nasal passages which lasts longer than 12 weeks. It will also be accompanied by one of three more symptoms. These are facial pressure or pain, discolored nasal discharge or post nasal drip, or loss of smell.
Chronic sinus infections might clear up and return worse than before, and they can also last for months. (18, 19)
Sinus infection will sometimes go away in about 10 days of its own accord.
On occasion it might be necessary to seek medical help straight away. This is indicated by a temperature over 100.4˚F (38˚C), or symptoms which last longer than 10 days or get progressively worse.
Medical treatment may be needed for recurrent incidences, or if a sinus infection isn’t helped by over the counter medications. (20)
Treatments for this condition include:
Antibiotics are considered one of the standard treatments for sinus infections which are bacterial in origin.
These drugs might need to be taken from three days up to a month. Longer treatments are generally recommended when the infection is severe or chronic.
Antibiotic resistance due to overuse and abuse has risen in recent times. Therefore these drugs will generally be prescribed only when necessary, if the infection has lasted more than about seven days.
This medication works by eliminating the bacteria which have caused the infection. They can take a short time to work but in the meantime might not help alleviate symptoms.
These nasal sprays can help relieve the symptoms of sinus infection, however, they should only be used short term. Some are available as over the counter medications and others might be prescribed.
They shrink swollen nasal passages, helping fluid drain from the sinuses.
When used too much they can cause a dependant condition where the nasal passages swell shut (rebound phenomenon). Make sure they are used only as advised by a doctor or pharmacist.
These drugs are able to help with inflammation caused by an allergic reaction. They may assist with swollen sinus and nasal passages.
Both antihistamines and nasal decongestants might contain drying agents. These can make mucus thicker, so use them with caution and only when advised.
Topical Nasal Corticosteroids
These are nasal sprays which are available by prescription. They help reduce and prevent inflammation in both sinus openings and nasal passages.
They can also help shrink, and prevent the return of, nasal polyps. When used as prescribed they are non addictive and may be used over a long period.
Saline Nasal Washes
These are saltwater solutions which can rinse away excess mucus and lubricate the nasal passages.
When treatment with medications fails, surgery might be considered. Usually performed endoscopically, it will aim to remove any tissue obstructing sinus drainage.
Surgery might also be considered if there are genetic defects contributing to sinusitis. Things like nasal polyps, closed nasal passages or deformed nasal bones can be corrected.
Surgery is usually performed using either local or general anesthetic and tends not to require a stay in hospital. (21)
What is a sinus infection? A sinus infection (sinusitis) is generally caused by a virus, or occasionally bacteria, which results in inflammation of the sinuses.
What are the signs of a sinus infection? Signs of this condition include a blocked stuffy nose and discolored nasal discharge. Further symptoms are pain or discomfort in the cheeks, nose or forehead and a loss of smell and taste. These can be accompanied by fever, fatigue, toothache, coughing and bad breath.
How do you develop a sinus infection? Sinus infections are mainly caused by a virus; occasionally they might be bacterial.
How are you diagnosed for a sinus infection? A doctor will take note of your symptoms a give you a physical examination. If the diagnosis cannot be confirmed they might take a nasal swab or request an imaging scan of the sinuses. (22)
What is the best treatment for a sinus infection? There are over the counter medications which might alleviate the symptoms of acute sinusitis until it clears. If the sinus infection persists antibiotics can be prescribed.
What are the long term complications if a sinus infection? While it is rare, infection can spread outside the sinuses to the eye sockets or the brain.
Is a sinus infection considered a disability? This condition is not considered a disability. However there are occasions, if the condition is persistent, when benefits might be paid. (23)
Is there a cure for a sinus infection? Treatments for this condition are successful in the majority of cases.
Is a sinus infection life threatening? This condition is not considered life threatening.
A sinus infection, generally caused by a virus or bacteria, results in inflammation of the sinuses and nasal passages. The main signs of this are a stuffy nose, facial discomfort or pain, nasal discharge and loss of smell and taste.
While the symptoms can be uncomfortable, fortunately this condition is easily diagnosed and treated.