Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Sinus infection is most often diagnosed based on a history and examination made by 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 sinus infection, are so expensive and not available in most doctors offices, most cases of sinus infection are initially diagnosed and treated based on clinical findings on examination. These physical findings may include:
redness and swelling of the nasal passages,
purulent (pus like) drainage from the nasal passages (the symptom most likely to clinically diagnose a sinus infection),
tenderness to percussion (tapping) over the cheeks or forehead region of the sinuses, and
swelling about the eyes and cheeks.
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 cells of allergy (eosinophils). Physicians prescribe antibiotics if 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, a procedure for directly looking in the back of the nasal passages with a small flexible fiber optic tube, may be used to directly look at the sinus openings (ostea) and check for obstruction 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 pathogen 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 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 is uncomfortable and requires local anesthesia; 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. Unfortunately, these procedures are also uncomfortable and need to be done by an otolaryngologist who may 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 such biopsy procedures and tissue removed by a surgeon, or by fungal culture and microscopic identification by a microbiologist or pathologist trained to identify fungi.
Most sore throats are caused by viruses or mechanical causes (such as mouth breathing) and can be treated successfully at home. However, a person should be seen by a health care professional if they have a sore throat that has a rapid onset, and is associated with a fever or tenderness of the front of the neck; a sore throat that causes the person to have difficulty swallowing (not just pain swallowing) or breathing; or if a sore throat lasts for more than a week.
Headaches can be divided into two categories: primary headaches and secondary headaches. Migraine headaches, tension headaches, and cluster headaches are considered primary headaches. Secondary headaches are caused by disease. Headache symptoms vary with the headache type. Over-the-counter pain relievers provide short-term relief for most headaches.
Allergic rhinitis symptoms include an itchy, runny nose, sneezing, itchy ears, eyes, and throat. Seasonal allergic rhinitis (also called hay fever) is usually caused by pollen in the air. Perennial allergic rhinitis is a type of chronic rhinitis and is a year–round problem, often caused by indoor allergens, such as dust, animal dander, and pollens that may exist at the time. Treatment of chronic rhinitis and post nasal drip are dependant upon the type of rhinitis condition.
An upper respiratory infection is a contagious infection of the structures of the upper respiratory tract, which includes the sinuses, nasal passages, pharynx, and larynx. Common causes of an upper respiratory infection include bacteria and viruses such as rhinoviruses, group A streptococci, influenza, respiratory syncytial, whooping cough, diphtheria, and Epstein-Barre. Examples of symptoms of upper respiratory infection include sneezing, sore throat, cough, fever, and nasal congestion. Treatment of upper respiratory infection are generally with OTC medication and home remedies.
Chronic cough is a cough that does not go away and is generally a symptom of another disorder such as asthma, allergic rhinitis, sinus infection, cigarette smoking, GERD, postnasal drip, bronchitis, pneumonia, medications, and less frequently tumors or other lung disease. Treatment of chronic cough is dependant upon the cause.
Although a fever technically is any body temperature above the normal of 98.6 degrees F. (37 degrees C.), in practice a person is usually not considered to have a significant fever until the temperature is above 100.4 degrees F (38 degrees C.). Fever is part of the body's own disease-fighting arsenal: rising body temperatures apparently are capable of killing off many disease- producing organisms.
The Eustachian tube is a membrane lined tube that connects the middle ear space to the back of the nose. Problems include partial or complete blockage which can cause popping, clicking, and ear fullness. Allergies, sinus and ear infections, or the common cold can cause this blockage, while altitude changes can cause symptoms in those persons with Eustachian tube problems. Treatment includes several maneuvers (swallowing, chewing gum, yawning etc.), which can be done to improve Eustachian tube function.
The common cold (viral upper respiratory tract infection) is a contagious illness that may be caused by various viruses. Symptoms include a stuffy nose, headache, cough, sore throat, and maybe a fever. Antibiotics have no effect upon the common cold, and there is no evidence that zinc and vitamin C are effective treatments.
Toothache usually refers to pain around the teeth or jaws. In most instances, toothaches are caused by tooth or jaw problems, such as a dental cavity, a cracked tooth, an exposed tooth root, gum disease, disease of the jaw joint (TMJ), or spasms of the muscles used for chewing. A toothache can also be caused by a problem that does not originate from a tooth or the jaw, like diseases of the heart (angina or heart attack), ear infections, and sinus infections. A thorough oral examination, which includes dental X-rays, can help determine the cause.
Asthma is a common disorder in which
chronic inflammation of the bronchial tubes (bronchi) makes them swell, narrowing the airways. Signs and symptoms include shortness of breath, chest tightness,
cough and wheezing.
An allergy refers to a misguided reaction by our immune system in response to bodily contact with certain foreign substances. When these allergens come in contact with the body, it causes the immune system to develop an allergic reaction in people who are allergic to it. It is estimated that 50 million North Americans are affected by allergic conditions. The parts of the body that are prone to react to allergies include the eyes, nose, lungs, skin, and stomach. Common allergic disorders include hay fever, asthma, allergic eyes, allergic eczema, hives, and allergic shock.
Cystic fibrosis is a disease of the mucus and sweat glands. Cystic fibrosis is an inherited disease. The outcome of the disease leaves the body malnourished, bulky and fouls smelling stools, vitamin insufficiency, gas, painful or swollen abdomen, infertility, susceptible to heat emergencies, and respiratory failure. There is no cure for cystic fibrosis, treatment of symptoms is used to manage the disease.
Sinus headache is caused by a sinus infection or inflammation of the sinus cavities. The primary symptom of a sinus infection is pain and increasing pressure overlying the area and associated tenderness to the touch. Treatment of a sinus headache depends on the cause.
Snoring, like all other sounds, is caused by vibrations that cause particles in the air to form sound waves. While we are asleep, turbulent air flow can cause the tissues of the nose and throat to vibrate and give rise to snoring. Any person can snore. Snoring is believed to occur in anywhere from 30% of women to over 45% of men. People who snore can have any body type. In general, as people get older and as they gain weight, snoring will worsen. Snoring can be caused by a number of things, including the sleep position, alcohol, medication, anatomical structure of the mouth and throat, stage of sleep, and mouth breathing.
Before treating a cold, the flu, or allergies with over-the-counter (OTC) medications, it's important to know what's causing the symptoms, which symptoms one wishes to relieve, and the active ingredients in the OTC product. Taking products that only contain the medications needed for relieving your symptoms prevents ingestion of unnecessary medications and reduces the chances of side effects.
Optic neuritis is inflammation of the optic nerve, the structure that connects the eye to the brain. The precise cause of optic neuritis is unknown, but it is thought to be a type of autoimmune disorder. Optic neuritis most commonly develops due to an autoimmune disorder that may be triggered by a viral infection.
Wegener's granulomatosis, a condition that usually affects young or middle-aged adults, is an inflammation of the arteries supplying blood to the sinuses, lungs, and kidneys. Symptoms of Wegener's granulomatosis include bloody sputum, fatigue, weight loss, joint pain, sinusitis, shortness of breath, and fever. Wegener's granulomatosis may be fatal within months without treatment. Treatment aims to stop inflammation with high doses of prednisone and cyclophosphamide.
Group A streptococcal infections are caused by group A streptococcus, a bacteria that causes a variety of health problems, including strep throat, impetigo, cellulitis, erysipelas, and scarlet fever. There are more than 10 million group A strep infections each year.
Hay fever (allergic rhinitis) is an irritation of the nose caused by pollen and is associated with the following allergic symptoms: nasal congestion, runny nose, sneezing, eye and nose itching, and tearing eyes. Avoidance of known allergens is the recommended treatment, but if this is not possible, antihistamines, decongestants, and nasal sprays may help alleviate symptoms.
Bad breath can result from poor oral hygien habits and may be a sign of other health problems. Bad breath, also called halitosis, can be made worse by the types of food you eat and other unhealthy lifestyle habits.
A deviate septum is a condition in which the bone and cartilage that divide the nasal cavity of the nose in half (nasal septum) is significantly off center or crooked. The causes of a deviated septum can be congenital, or develop after a trauma or injury to the nose. Symptoms of a deviated septum include nasal congestion, recurrent sinus infections, nosebleeds, headache, facial pain, postnasal drip, snoring, and loud breathing. A deviated septum can be relieved with medications, and if necessary surgery, called a septoplasty.
Acid backing up into the larynx (voice box), it causes reflux laryngitis. Irritation of the lining of the esophagus, larynx, and throat can lead to esophagitis, sinusitis, strictures, hoarseness, throat clearing, swallowing problems, asthma, chronic cough, and more. Typical symptoms of reflux laryngitis include heartburn, hoarseness, or a sensation of a foreign body in the throat. Reflux laryngitis can be treated with OTC medication, prescription medication, and lifestyle changes.
Kids get headaches and migraines too. Many adults with headaches started having them as kids, in fact, 20% of adult headache sufferers say their headaches started before age 10, and 50% report their headaches started before age 20.
Reduction of the sense of smell is termed hyposmia. Total inability to detect odors is termed anosmia. Smell disorders have many causes. Most people who develop a smell disorder have recently experienced an illness or an injury.
Cleidocranial dysplasia is a genetic condition. Cleidocranial dysplasia is also referred to as cleidocranial dysostosis and cleidocranial dysostosis. Cleidocranial dysplasia primarily affects bone and teeth development. Symptoms and signs may vary widely with severity. The RUNX2 is the gene that is related to cleidocranial dysplasia. Cleidocranial dysplasia is an autosomal dominant pattern inherited condition.
Occupational asthma is a type of asthma caused by exposure to a substance in the workplace. Symptoms and signs include wheezing, chest tightness, and shortness of breath. The usual treatment for occupational asthma involves removal from exposure and the use of bronchodilators and inhaled anti-inflammatory medicines.
Exercise-induced asthma is asthma triggered by vigorous exercise. Symptoms include coughing, shortness of breath, chest tightness, wheezing, and fatigue while exercising. Preventing exercise-induced asthma attacks involves using inhaled medicines before exercising, performing warm-up exercises and cooling down afterward, avoiding exercising outdoors when pollen counts are high, restricting exercise when you have a viral infection, and wearing a mask over your nose and mouth when exercising in cold weather.
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