Acute sinusitis (also known as: Acute rhinosinusitis or sinus infection) is a common upper respiratory tract infection. Sinuses are the cavities present around the nasal passages. There are four pairs of sinuses and are known as paranasal sinuses. They are:
- Frontal sinuses – present above the eyes near the eyebrow region
- Maxillary sinuses – present below the cheek and above teeth
- Sphenoidal sinuses – present behind the upper part of the nose between the eyes
- Ethmoidal sinuses – present behind the bridge of the nose
Acute sinusitis is the inflammation of the sinuses. It is contagious if the infection is caused by a virus. Sinusitis can affect different sinuses at the same time.
The symptoms of acute sinusitis mimic the symptoms of common cold. Sinusitis usually gets relieved but persistent sinusitis can cause life threatening complications. So, seek medical attention immediately if there is a severe nasal congestion for more than 3 days.
Acute sinusitis is often caused by common cold which is usually due to a virus. Other causes are bacterial or fungal infections. Fungal infections are common in patients with diabetes and immunocompromised patients.
Common bacteria that causes sinusitis are:
- Streptococcus pneumoniae
- Hemophilus influenzae
- Pseudomonas aeruginosa
- Staphylococcus aureus
- Anerobic bacteria
Sinusitis is said to be acute if the duration of symptoms is less than 4 weeks.
The symptoms are of sudden onset and typically last for around 10 days. The symptoms are:
- Nasal congestion
- Discharge from the nose
- Pain in the affected sinus
- Bad breath
- Facial pain or edema
- Reduced sense of smell
- Change in taste
A weak immune system is the major risk factor for acute sinusitis. Other risk factors of acute sinusitis are:
- Elderly people
- Frequent air travel
- Frequent swimming in chlorinated pools
- Irregularity in nasal septum
- Allergic rhinitis or hay fever
- Nasal polyps (small growths on the lining of the nose)
- Regular exposure to environmental irritants such as smoke or chlorine
- Dental infection
- Kartagener syndrome, a genetic disorder in which there is an impairment in the function of cilia of the respiratory tract
- Presence of tumors in nasal cavity
Complications of Sinusitis
Sinusitis can cause life-threatening complications if the infection spreads to central nervous system (CNS). However, early management of sinusitis can help avoid serious complications.
- Preseptal cellulitis – Infection of the eyelid and surrounding tissues in front of the orbital septum
- Orbital cellulitis – Infection of the orbital tissues behind the orbital septum
- Subperiosteal abscess – Collection of bacteria, fluid and pus in the layer beneath the bone due to infection
- Orbital abscess – Collection of bacteria and pus in the orbit, the cavity that encloses the eye
- Chronic nasal obstruction – Prolonged nasal congestion which lasts more than 4 weeks
- Brain abscess – Collection of bacteria and pus in the brain
- Cerebral empyema or subdural abscess – Collection of bacteria and pus between the dura mater and arachnoid mater (the outer meninges of the brain)
- Meningitis – Inflammation of the meninges (membranes of the brain)
Diagnosis and Treatment
Diagnosis of acute sinusitis is usually made by obtaining the medical history and examining the clinical signs and symptoms.
- Persistent symptoms such as nasal congestion, runny nose, and cough for > 10 days
- Temperature > 38.5 C for > 3 days
Nasal culture: A culture of the nasal drainage can help determine the causative organism and antibiotic that can treat the infection.
Nasal endoscopy: An endoscope, a thin tube with a light source at its end, is inserted into the nose to view any abnormalities present in the nose.
If you are at risk of acute sinusitis, it is recommended to follow preventative measures. These include:
- Stay away or avoid exposure to irritants such as chemicals or cigarette smoke.
- Avoid upper respiratory tract infections such as common cold by staying away from people affected with it and washing hands regularly.
- Avoid sharing personal items like towels and glasses.
- Consume a healthy diet to boost your immunity.
Use a humidifier at home.
Inhalation of steam or vaporizer and saline nasal spray can provide symptomatic relief in patients with acute sinusitis. It also helps to reduce swelling and open the blocked sinuses. Decongestants can be taken in case of severe congestion. Corticosteroids such as fluticasone and budesonide can treat inflammation. Over-the-counter drugs such as aspirin and ibuprofen can be taken to relieve headache.
Antibiotics are prescribed if the symptoms persist beyond 7-10 days of conservative treatment. Generally, duration of antibiotic therapy can be 10 to 21 days. Treatment of bacterial sinusitis includes:
- Mild cases: Amoxicillin is the first drug of choice. Penicillin and clindamycin are also prescribed. If the person has a history of penicillin allergy, erythromycin or clarithromycin are the alternatives. Erythromycin is prescribed for pregnant women.
- In the presence of periorbital or intracranial complications, high dose and intravenous administration of antibiotic are recommended.
In very rare cases of acute sinusitis, if treatment fails, surgical drainage may be needed. Drainage reduces the intensity of pain and slows down disease progression.
Endoscopic surgery is performed if there are nasal polyps or structural abnormalities such as deviation in nasal septum. Surgery can also be performed to widen the sinus openings.
Home remedies and some foods can provide symptomatic relief from acute sinusitis. Remedies to be followed are:
- Keep yourself hydrated adequately by increasing intake of fluids.
- Steam inhalation can help to relieve from nasal blockage. During steam inhalation, add few drops of eucalyptus oil to the hot water and inhale the vapors.
- Ginger tea can also help relieve symptoms.
- Avoid mucus forming foods such as chocolate, fried and processed foods, eggs, and sugar products.
- Gargle with warm saltwater if you have sore throat. Gargling can also help in improving the sense of taste.
Foods that helps in treating sinusitis are:
- Spicy food
- Herbal teas
- Chicken soup
- Apple cider vinegar
Food items that may worsen the condition are:
- Processed food
Frequently Asked Questions
1. Is milk good for sinus congestion?
No, milk is not good for sinus congestion as it thickens the mucus and promotes microbial growth. Thus, consumption of milk should be avoided.
2. Which sinus is mostly affected in sinusitis?
Most commonly affected sinuses are maxillary followed by ethmoid, frontal, and sphenoid sinuses.
3. How long does acute infection lasts for?
Acute infection typically lasts for 4 weeks or less.
4. How does garlic helps in treating sinusitis?
Garlic contain allicin, an enzyme, which helps in destroying viruses and bacteria that causes sinusitis.