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Sinusitis or Sinus Infection
Sinusitis refers to a viral or bacterial infection of the sinuses. Around the eyes, under the cheekbones, and high into the nasal passages, there are cavities in the bone or "air pockets" known as sinuses. These spaces can become infected by a virus, or bacteria leading to inflammation of the sinuses, producing the classic symptoms associated with sinusitis. Patients with a long history for allergic rhinitis have an increased incidence of secondary bacterial or viral infection of the sinuses. Common symptoms of sinusitis include runny nose and posterior nasal drip which can result in a yellowish or greenish nasal discharge. Dull facial pain or headache in the area of the sinuses is common. Tenderness may also be noted over the lower forehead or cheekbones. Congestion, fever, ear pain, and sore throat often accompany sinusitis.
A cough can develop secondarily to the constant posterior nasal drip that inflames the trachea (wind-pipe). Evaluation is by history and physical examination. Blood tests for blood count may be done in special cases. X-rays of the sinuses can show characteristic changes associated with this infection. Culture of the sinus drainage can yield information on the type of infection and its susceptibility to antibiotics. Patients who have an uncertain diagnosis may have a CT scan performed of the sinuses. Treatment is with decongestants (e.g. pseudoephedrine hydrochloride, phenylpropanolamine) to "dry up" excess secretions. Antihistamines (Hismanal, Seldane) are also helpful in selected cases. Antibiotics are indicated in those cases with fever, colored nasal discharge, or x-ray findings which are consistent with sinusitis. Antibiotic therapy is often necessary for 3-4 weeks duration to reduce the likelihood of recurrence. Patients will be encouraged to drink plenty of fluids. In most cases, bed rest, fever control, and follow-up with an ENT physician is advisable.
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