Sinusitis

Sinusitis refers to inflammation of the sinuses that occurs with a viral, bacterial, or fungal infection.

Causes, incidence, and risk factors

The sinuses are air-filled spaces in the skull (behind the forehead, nasal bones, cheeks, and eyes) that are lined with mucus membranes. Healthy sinuses contain no bacteria or other germs. Usually, mucus is able to drain out and air is able to circulate.
When the sinus openings become blocked or too much mucus builds up, bacteria and other germs can grow more easily.

Sinusitis can occur from one of these conditions:

  • Small hairs (cilia) in the sinuses, which help move mucus out, do not work properly due to some medical conditions.
  • Colds and allergies may cause too much mucus to be made or block the opening of the sinuses
  • A deviated nasal septum, nasal bone spur, or nasal polyps may block the opening of the sinuses.

Sinusitis can be:

  • Acute — symptoms last up to 4 weeks
  • Sub-acute — symptoms last 4 – 12 weeks
  • Chronic — symptoms last 3 months or longer
    • Acute sinusitis is usually caused by a bacterial infection in the sinuses that results from an upper respiratory tract infection. Chronic sinusitis refers to long-term swelling and inflammation of the sinuses that may be caused by bacteria or a fungus.

The following may increase your risk or your child’s risk of developing sinusitis:

  • Allergic rhinitis or hay fever
  • Cystic fibrosis
  • Day care
  • Diseases that prevent the cilia from working properly, such as Kartagener syndrome and immotile cilia syndrome.
  • Changes in altitude (flying or scuba diving)
  • Large adenoids
  • Smoking
  • Tooth infections (rare)
  • Weakened immune system from HIV or chemotherapy
Symptoms

The classic symptoms of acute sinusitis in adults usually follow a cold that does not improve, or one that worsens after 5 – 7 days of symptoms. Symptoms include:

  • Bad breath or loss of smell
  • Cough, often worse at night
  • Fatigue and generally not feeling well
  • Fever
  • Headache — pressure-like pain, pain behind the eyes, toothache, or facial tenderness
  • Nasal congestion and discharge
  • Sore throat and postnasal drip
    • Symptoms of chronic sinusitis are the same as those of acute sinusitis, but tend to be milder and last longer than 12 weeks.

Symptoms of sinusitis in children include:

  • Cold or respiratory illness that has been improving and then begins to get worse
  • High fever, along with a darkened nasal discharge, for at least 3 days
  • Nasal discharge, with or without a cough, that has been present for more than 10 days and is not improving