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Acute sinusitis

Acute sinusitis is the swelling and inflammation of the lining of paranasal sinuses, an air-filled extension of the nasal cavity. It may obstruct fluid drainage leading to the accumulation of mucus within the sinuses.

Breathing through your nose may become difficult. You may suffer from a headache or throbbing facial pain. The skin around your eyes may swell.

The common cold is a common cause of acute sinusitis. The symptoms usually go away within 7-10 days if there is no bacterial infection. You can relieve the symptoms with home remedies. If your symptoms do not improve with medications and persist for more than 3 months, you may suffer from chronic sinusitis.

Symptoms of acute sinusitis

Signs and symptoms of acute sinusitis are:

• You have thick, yellow, or greenish nasal discharge or post-nasal drip.
• You have nasal congestion or breathing difficulty.
• You feel pain, tenderness, swelling, and pressure in the upper area of your face, including the forehead, eyes, nose, and cheeks, and the symptoms aggravate when bending forward.

Other possible signs and symptoms include cough, fever, fatigue, headache, ear pressure, bad breath, aching teeth, and changes in the sense of smell.

When should I see a doctor?

In most cases, acute sinusitis resolves by itself and does not require medical attention. 

However, consult a doctor when:

• Your symptoms persist for more than one week.
• Your symptoms aggravate after they seem to be better.
• You have a fever for a prolonged period. 
• You have a medical history of acute or chronic sinusitis.

You should seek immediate medical attention if you experience symptoms indicating a severe infection:

• You experience pain, swelling, and redness around your eyes.
• You have a high fever.
• You have confusion.
• You have double vision or your vision changes.
• Your neck is stiff. 

What is the cause?

Common cold - a viral infection - is the most common cause of acute sinusitis. A bacterial infection may also supervene in some cases.

Risk factors

The risk of sinusitis is higher if:

• You suffer from an allergy or hay fever.
• You have a common cold.
• You have abnormal nasal passage, including tumors, nasal polyps, and deviated nasal septum. 
• You suffer from other medical conditions, including cystic fibrosis, or you are immunocompromised with HIV/AIDS.
• You smoke or have secondhand smoke exposure.

What are the complications of sinusitis?

Complications of acute sinusitis are not common, and severe complications rarely occur. 

However, possible complications that may occur are:

• Chronic sinusitis. Acute sinusitis may superimpose on underlying chronic sinusitis, which lasts more than 3 months.
• Meningitis is an infection and inflammation of the membranes and fluid around your brain and spinal cord.
• Osteomyelitis (bone infection) and cellulitis (skin and soft tissue infection) are by direct extension of the sinus infection.
• Eye problems such as decreased vision or vision loss, which may be permanent, can result from the infected eye socket.

How to prevent sinusitis?

To lower your risk of acute sinusitis, you can follow the following steps:

• Avoid being among people who are sick with common colds or infections. Sanitize your hands before meals.
• Consult your doctor about how to control your allergic symptoms.
• Refrain from being in an air-polluted area or around people who smoke because your nasal passage may be irritated and inflamed.
• Use a humidifier to moisturize air with low humidity to prevent sinusitis. Maintain the cleanliness of the humidifier with regular cleaning to prevent mold growth.

How is sinusitis diagnosed?

Your doctor will inquire about your symptoms, and check for the tender area, take a look inside your nasal passages to see if there is an abnormality that can help with the diagnosis of sinusitis. 

Special studies and investigations that help confirm the diagnosis and exclude other conditions are:

• Nasal endoscopy: Your doctor will insert an endoscope (thin, flexible tube) with fiber-optic light for direct inspection of the interior of the sinus cavity.
• Imaging studies: A CT scan of your nasal passages can help detect abnormalities or possible complications. For uncomplicated acute sinusitis, there is no need to do an imaging study.
• Nasal and sinus samples: Tests on tissue samples are usually not necessary. However, if symptoms do not respond to treatment or are worse, a culture of the nasal samples can help confirm the diagnosis of bacterial infection. 
• Allergy testing: If allergies are considered a possible cause, get skin prick testing to confirm the cause of the acute symptoms. Allergy testing is easy and painless and helps identify the allergen causing acute sinusitis.

What is the treatment method?

Acute sinusitis usually resolves on its own. You can relieve your symptoms as follows:

• Saline nasal spray to rinse your nose during the day to clear your sinuses.
• Nasal corticosteroids are anti-inflammatory nasal sprays to prevent and treat symptoms.
• Decongestants are in the form of liquids, pills, and sprays available at a pharmacy. However, avoid long-term use because nasal decongestants can cause rebound congestion when stopping the medication.
• Allergy drugs can relieve the symptoms of allergic sinusitis.
• Pain-relievers.

Antibiotics

Acute sinusitis is most often a consequence of a viral infection, not a bacterial one; therefore, there is no need for antibiotics. Acute sinusitis may resolve without treatment. Before antibiotics prescription, your doctor would observe if your symptoms aggravate.

Since viral infection causes most cases of acute sinusitis, which usually resolves without specific treatment, antibiotics are not required. Your doctor may consider giving you antibiotics if you have a severe, long-lasting course of sinusitis. You should complete the course of antibiotics even if you feel better. An incomplete course of antibiotics can allow your symptoms to recur. 

Home remedies and lifestyle modification

The following self-care tips can help treat your symptoms:

• Taking a rest can speed up your recovery and help fight infection.
• Drink plenty of water.
• Apply a warm pack to your nose to relieve pressure in the nasal cavities.
• Moisten your nasal passage by inhaling water vapors. Position your head, covered in a towel, over a bowl of hot water, or take a hot shower, and breathing in the water vapors can help drain nasal discharge with symptom relief.
• Rinse your nose with nasal saline irrigation or a nasal wash squeeze bottle to clear your nasal passages.