If you let sinus infection go untreated, it could lead to rare but serious complications such as chronic sinusitis that spreads to the surrounding areas and the larynx, eyes, and brain. Potential complications of untreated sinus infection include:
- Chronic sinusitis
- Difficulty breathing
- Hyposmia (reduced sense of smell)
- Anosmia (complete loss of the sense of smell)
- Laryngitis (inflammation of the larynx)
- Dacryocystitis (inflammation or infection of the lacrimal glands)
- Orbital cellulitis or abscess (inflammation of the orbit of the eye)
- Meningitis (inflammation of the meninges)
- Brain abscess (pus-filled pockets inside the brain)
- Frontal bone osteomyelitis (infection of the frontal bone)
- Cavernous sinus thrombosis (formation of blood clot forms inside a hollow space at the base of the brain)
A sinus infection that lasts longer than a month without treatment requires a visit to the ear, nose, and throat (ENT) doctor. If your sinus infection does not clear after 12 weeks of antibiotic therapy, it needs to be treated more aggressively.
What causes sinusitis?
Sinusitis is the inflammation or infection of the sinuses, which are empty spaces between the eyes and cheekbones. These empty spaces normally drain fluid into the nose and throat. If they become blocked however, due to dust, pollution, or microbes (viruses, bacteria, or fungi), it can result in sinusitis.
Conditions that can cause sinus blockage include:
- Common cold (the same virus that causes the common cold often causes sinusitis)
- Allergic rhinitis (swelling of the lining of the nose caused by allergens such as pollen)
- Nasal polyps (small, fleshy growths in the lining of the nose)
- Deviated nasal septum (tilting of the middle bony part or nasal septum in the nostrils toward either side)
What are symptoms of sinusitis?
Sinusitis causes symptoms similar to a cold, such as runny nose or congestion. Pain and pressure in the head and face are common distinguishing features between the two.
Additional symptoms of sinusitis may include:
What are the stages of a sinus infection?
Stages or types of sinus infection are classified depending on how long the symptoms last:
- Acute sinusitis: Starts with a runny or stuffy nose and facial pain and lasts for 2-4 weeks.
- Subacute sinusitis: Symptoms persist for 4-12 weeks.
- Chronic sinusitis: Symptoms linger beyond 12 weeks.
- Recurrent sinusitis: Repeated attacks of sinusitis several times a year.
How is sinusitis diagnosed?
Your doctor will take your medical history, ask about your symptoms, and perform a physical examination to make a diagnosis of sinusitis. During the physical exam, your doctor will check the inside of your nose with a speculum and flashlight.
Though not routinely ordered, tests done to diagnose sinusitis include:
- Blood tests: Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) can determine the severity of the infection.
- Culture test: This involves taking a sample of discharge (swab) of the nose or sinus to detect the presence of microorganisms.
- Allergy test: This is usually done if you develop recurrent sinus infections.
How is sinusitis treated?
In the initial stages of sinusitis, you can manage symptoms the way you would a viral sinus infection, which goes away within 10-14 days:
- Drink plenty of fluids.
- Apply a warm towel on your face for 5-10 minutes at a time 5 times a day.
- Inhale steam from a hot shower or bath.
- Use saline nasal drops in your nostrils, which loosens trapped mucus.
- Try over-the-counter medications such as nasal decongestants to help relieve pain and pressure in the head and face.
If your sinus infection does not clear up within 14 days, it may be due to bacteria or fungi:
- If it is a bacterial infection, it will need to be treated with antibiotics.
- If it is a fungal infection, your doctor will prescribe antifungal medicines, steroids, or surgery (in severe cases).
If you have persistent sinus problems, your doctor may recommend surgery to open the blocked sinuses or to create a wider sinus opening. Surgical options include:
- Simple balloon sinuplasty and irrigation (use of small balloon catheters that inflate to drain the nasal sinuses)
- Endoscopic sinus surgery (removal of tissue and bone to create a wider opening)
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Brook I. Acute Sinusitis. Medscape. https://emedicine.medscape.com/article/232670-overview
Brook I. Chronic Sinusitis. Medscape. https://emedicine.medscape.com/article/232791-overview
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