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Things to know about a sinus infection (sinusitis)
The majority of doctors think that most people do not transmit sinus infections except in rare instances, and conclude that sinus infections are not contagious. Sinus infections usually begin with the symptoms of a cold (for example, a runny nose, occasional cough and/or mild fever), and then develop into pain and pressure in the sinus cavities. About 7 to 10 days after initial cold-like symptoms other symptoms develop that suggest you may have a sinus infection. Sinus infection symptoms include
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A sinus is a hollow, air-filled cavity.Source: MedicineNet What are the sinuses? How many do we have?A sinus is a hollow, air-filled cavity. For the purposes of this article, a sinus will refer to those hollow cavities that are in the skull and connected to the nasal airway by a narrow hole in the bone (ostium). Normally all sinuses are open to the nasal airway through an ostium. Humans have four pairs of these cavities each referred to as the
The four pairs of sinuses are often described as a unit and termed the "paranasal sinuses." The cells of the inner lining of each sinus are mucus-secreting cells, epithelial cells, and some cells that are part of the immune system (macrophages, lymphocytes, and eosinophils). Functions of the sinuses include humidifying and warming inspired air, insulation of surrounding structures (eyes, nerves), increasing voice resonance, and as buffers against facial trauma. The sinuses decrease the weight of the skull. If the inflammation hinders the clearance of mucous or blocks the natural ostium, the inflammation may progress into a bacterial infection.
Sinusitis is one of the more common conditions that can afflict people throughout their lives.Source: iStock / MedicineNet What is a sinus infection or sinusitis?Inflammation of the air cavities within the passages of the nose (paranasal sinuses) is referred to as sinusitis. Sinusitis can be caused by infection (sinus infection), but also can be caused by allergy and chemical irritation of the sinuses. A sinus infection (infectious sinusitis) occurs when a virus, bacterium, or fungus grows within a sinus.
About 30 million adults have "sinusitis." Colds differ from sinusitis and are only caused by viruses and last about seven to 10 days while sinusitis may have many different causes (infectious and non-infectious), and usually last longer with more pronounced and variable symptoms.
Most patients have several signs and symptoms at the same time.Source: Wikipedia – Bruce Blaus 18 signs and symptoms of sinus infection or sinusitis
There are many signs and symptoms of sinusitis and sinus infections. The following is a summary of the predominant ones (18 total) that may occur. Most patients have several signs and symptoms at the same time. Others may have some symptoms that are intermittent; most do not have all symptoms at once. The signs and symptoms of a sinus infection or sinusitis include the following:
This irrigation is accomplished with a "Neti-Pot" or a sinus rinse kit (sometimes termed a nasal bidet).Source: WebMD - Brayden Knell What home remedies help soothe a sinus infection? 9 Tips
The nine common home remedies to treat sinus infection include:
Sinus infections caused by viruses can use homes (over-the-counter, OTC) treatments such as pain and fever medications (acetaminophen [Tylenol]), decongestants, and mucolytics. In addition, some health care professionals suggest nasal irrigation or a sinus rinse solution to help relieve symptoms of sinus infections, even chronic sinusitis symptoms. This irrigation is accomplished with a "Neti-Pot" or a sinus rinse kit (sometimes termed a nasal bidet). Bacterial and fungal sinus infections usually require antibiotic or antifungal therapy so home treatments without them are often not successful. However, some authors suggest home treatments may reduce symptoms after medical therapy has begun; some healthcare professionals recommend nasal irrigation after sinus surgery.
The sinus openings (ostea) may be blocked by swelling of the tissue lining and adjacent nasal passage tissue.Source: Wikipedia - © Nevit Dilmen What causes sinus infections or sinusitis?
Sinus infections or sinusitis may be caused by anything that interferes with airflow into the sinuses and the drainage of mucus out of the sinuses. The sinus openings (ostea) may be blocked by swelling of the tissue lining and adjacent nasal passage tissue, for example with Other causes of sinus infections or sinusitis
The sinus openings (ostea) may be blocked by swelling of the tissue lining and adjacent nasal passage tissue.Source: iStock What are the six types of sinusitis and sinus infections?Sinusitis may be classified in several ways, based on its duration (acute, subacute, or chronic) and the type of inflammation (either infectious or noninfectious). The term rhinosinusitis is used to imply that both the nose and sinuses are involved and is becoming the preferred term over sinusitis.
There is no medical consensus on the above time periods.
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Sinus infection is most often diagnosed based on the history and examination of a doctor.Source: iStock What tests diagnose the cause of sinus infections and sinusitis?Sinus infection is most often diagnosed based on the history and examination of a doctor. Because plain X-ray studies of the sinuses may be misleading and procedures such as CT and MRI scans, which are much more sensitive in their ability to diagnose a sinus infection, are so expensive and not available in most doctors' offices, most sinus infections are initially diagnosed and treated based on clinical findings on examination. These physical findings may include
Occasionally, nasal secretions are examined for secreted cells that may help differentiate between infectious and allergic sinusitis. Infectious sinusitis may show specialized cells of infection (polymorphonuclear cells) while allergic sinusitis may show specialized white blood cells of allergy (eosinophils). Physicians prescribe antibiotics if a bacterial infection is suspected. Antibiotics are not effective against viral infections; many physicians then treat the symptoms. If sinus infection fails to respond to the initial treatment prescribed, then more in-depth studies such as CT or MRI scans may be performed. Ultrasound has been used to diagnose sinus infections in pregnant women but is not as accurate as CT or MRI. Rhinoscopy or endoscopy, a procedure for directly looking in the back of the nasal passages with a small flexible fiberoptic tube, may be used to directly look at the sinus openings and check for blockage of these openings by either swelling or growths. It may sometimes be necessary to perform a needle aspiration (needle puncture) of a sinus to get infected material to culture to determine what microbe is actually causing the sinus infection. Cultures of the nasal passages are rarely helpful in determining what bacteria or fungus is causing a sinus infection since the nasal passages are often normally colonized by non-infecting bacteria. The needle puncture procedure is usually done by an otolaryngologist when treatments have failed to alleviate the disease. The procedure requires local anesthesia to minimize any discomfort; some patients require general anesthesia. The sinus is aspirated, the contents sent for culture and staining, and the sinus may be flushed with a saline solution. This is technically the most accurate way to diagnose infectious sinusitis. In addition, both rigid and flexible endoscopy has been used to obtain diagnostic material from sinuses. These procedures are usually done by an otolaryngologist under topical and local anesthesia. Occasionally, there may be a need to sedate the patient. Some investigators suggest that endoscopy specimens are comparable to those obtained by needle puncture. Fungal infections are usually diagnosed by biopsy procedures and tissue removed by a surgeon, or by fungal culture and microscopic identification by a microbiologist or pathologist trained to identify fungi. Allergic fungal sinusitis (emphasis on allergic) is an inflammatory response to fungal elements in the sinus cavity and is suspected based on certain CT imaging characteristics as well as the history and physical exam. Which types of doctors treat sinusitis and sinus infections?
Antibiotics are not necessary for sinusitis caused by a virus.Source: Bigstock What antibiotics and drugs treat and cure sinus infections and sinusitis?
Viral sinusitisAntibiotics are not necessary for sinusitis caused by a virus. Frequently recommended treatments include pain and fever medications, like
Bacterial sinusitisBacterial infection of the sinuses is suspected when facial pain, nasal discharge resembling pus, and other symptoms last longer than a week and are not responding to over-the-counter (OTC) nasal medications. Acute sinus bacterial infection usually is treated with antibiotics aimed at treating the most common bacteria known to cause a sinus infection. It is unusual to get a reliable culture without aspirating the sinuses. The five most common bacteria causing sinus infections include the following: Antibiotic treatment for sinus infections must be able to kill these five types of bacteria. Amoxicillin (Amoxil) is acceptable for uncomplicated acute sinus infections; however, many doctors prescribe amoxicillin-clavulanate (Augmentin) as the first-line antibiotic to treat a possible bacterial infection of the sinuses. Amoxicillin usually is effective against most strains of bacteria. Penicillin allergies and treatment for sinusitisOther antibiotics may be used as a first choice if you are allergic to penicillin. Examples include If you don't improve after 5 days of taking the antibiotic, contact your doctor because he may want to switch antibiotics to one of the five listed above or amoxicillin-clavulanate (Augmentin). Generally, an effective antibiotic needs to be continued for a minimum of 10-14 days. However, it is not unusual to treat sinus infections for 14-21 days. Some antibiotics now are thought to reduce inflammation, independent of the antibacterial activity.
In rare instances or in natural disasters, fungal infections (termed zygomycosis or mucormycosis) may develop in debilitated people. Death rates of 50%-85% have been reported for patients with these sinus infections.Source: iStock What decongestants and nasal sprays soothe or cure sinus infections or sinusitis?Taking decongestants (pseudoephedrine) and mucolytics (guaifenesin) orally may be helpful in assisting drainage of sinus infection. The treatment of chronic forms of sinus infection requires longer courses of medications, such as Augmentin, and may require a sinus drainage procedure. This drainage typically requires a surgical operation to open the blocked sinus under general anesthesia. In general, antihistamines should be avoided unless it is felt that the sinusitis sinus infection is due to allergies, such as pollens, dander, or other environmental causes. It is likely that the use of a topical nasal steroid spray will help reduce swelling in the allergic individual without the drying that is caused by using antihistamines although both are occasionally used. Oral steroids may be prescribed to reduce acute inflammation and to help with chronic inflammation in cases with or without polyps and in allergic fungal sinusitis. In many people, allergic sinusitis develops first, and later, bacterial infection occurs. For these individuals, early treatment of allergic sinusitis may prevent the development of secondary bacterial sinusitis. In rare instances or in natural disasters, fungal infections (termed zygomycosis or mucormycosis) may develop in debilitated people. Death rates of 50%-85% have been reported for patients with these sinus infections. Treatment relies on early diagnosis followed by immediate surgical debridement, antifungal drugs, (mainly Amphotericin B), and stabilizing any underlying health problem such as diabetes.
It is possible for sinus infection to cause a direct extension of infection into the brain through a sinus wall, creating a life-threatening emergencySource: iStock What are complications of a sinus infection or sinusitis?
While serious complications do not occur frequently, it is possible for a sinus infection to cause a direct extension of infection into the brain through a sinus wall, creating a life-threatening emergency (for example, meningitis or brain abscess). In addition, other adjacent structures can become infected and develop problems, such as osteomyelitis of bones in the skull and infection around the eye (orbital cellulitis). Rarely, these infections (mainly bacterial and fungal organisms) may cause death. The most susceptible individuals to complications are patients with suppressed immune systems, diabetes, and relatively rarely from multiple trauma injuries that may occur in natural disasters.
If you are prone to recurrent bouts of a "yearly sinus infection" it may be important to consider allergy testing to see if this is the underlying cause of the recurring problem.Source: iStock Is it possible to prevent sinus infections or sinusitis?Currently, there are no vaccines designed specifically against infectious sinusitis or sinus infections. However, there are vaccines against viruses (influenza) and bacteria (pneumococci) that may cause some infectious sinusitis. Vaccination against pathogens known to cause infectious sinusitis may indirectly reduce or prevent the chance of getting the disease; however, no specific studies support this assumption. Fungal vaccines against sinusitis are not available, currently. If you are prone to recurrent bouts of a "yearly sinus infection" it may be important to consider allergy testing to see if this is the underlying cause of the recurring problem. Treatment of the allergy may prevent secondary bacterial sinus infections. In addition, sinus infections may be due to other problems such as nasal polyps, tumors, or diseases that obstruct normal mucus flow. Treatment of these underlying causes may prevent recurrent sinus infections.
Medically Reviewed on 4/15/2022 References Brook, Itzhak. "Acute Sinusitis." Medscape. Feb. 23, 2021. <http://emedicine.medscape.com/article/232670-overview>. Brook, Itzhak. "Chronic Sinusitis." Medscape. Jan. 19, 2022. <http://emedicine.medscape.com/article/232791-overview>. NeilMed Pharmaceuticals, Inc. NeilMed Sinusrinse Video. <http://www.neilmed.com/usa/video.php> United States. U.S. Food & Drug Administration. "Is Rinsing Your Sinuses With Neti Pots Safe?" Jan. 24, 2017. <http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm316375.htm> |