Inflammation of the air cavities within the passages of the nose (paranasal sinuses) is referred to as sinusitis. Sinusitis can be caused by infection (sinus infection), but also can be caused by allergy and chemical irritation of the sinuses. A sinus infection (infectious sinusitis) occurs when a virus, bacterium, or a fungus grows within a sinus.
Sinusitis is one of the more common conditions that can afflict people throughout their lives. Sinusitis commonly occurs when environmental pollens irritate the nasal passages, such as with hay fever. Sinusitis can also result from irritants, such as chemicals or the use and/or abuse of over-the-counter (OTC) nasal sprays, and illegal substances that may be snorted or inhaled through the nose. About 30 million adults have “sinusitis.” Colds differ from sinusitis and are only caused by viruses and last about seven to 10 days while sinusitis may have many different causes (infectious and non-infectious), and usually last longer with more pronounced and variable symptoms.
What are the types of sinusitis and sinus infections?
Sinusitis may be classified in several ways, based on its duration (acute, subacute, or chronic) and the type of inflammation (either infectious or noninfectious). The term rhinosinusitis is used to imply that both the nose and sinuses are involved an is becoming the preferred term over sinusitis.
•Acute sinus infection (acute sinusitis or acute bacterial rhinosinusitis) usually lasts less than 3-5 days.
•Subacute sinus infection lasts one to three months.
•Chronic sinus infection greater than three months. Chronic sinusitis may be further sub-classified into chronic sinusitis with or without nasal polyps, or allergic fungal sinusitis.
•Recurrent sinusitis has several sinusitis attacks every year.
There is no medical consensus on the above time periods.
Infected sinusitis usually is caused by uncomplicated virus infection. Less frequently, bacterial growth causes sinus infection and fungal sinus infection is very infrequent. Subacute and chronic forms of sinus infection usually are the result of incomplete treatment of an acute sinus infection.
Noninfectious sinusitis is caused by irritants and allergic conditions and follows the same general time line for acute, subacute and chronic as infectious sinusitis.
What tests diagnose the cause of sinus infections and sinusitis?
Sinus infection is most often diagnosed based on the history and examination of 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 sinus infections 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 white blood 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 or endoscopy, a procedure for directly looking in the back of the nasal passages with a small flexible fiberoptic tube, may be used to directly look
Sinusitis signs and symptoms include:
sinus headache,facial tenderness,
pressure or pain in the sinuses, in the ears and teeth,fever,cloudy discolored nasal or postnasal drainage,feeling of nasal stuffiness,sore throat,cough, and
occasionally facial swelling.
Symptoms of a bacterial sinus infection include:
facial pain,pus-like nasal discharge, and symptoms that persist for longer than a week and that are not responding to over-the-counter (OTC) nasal medications.
Sinus infection is generally diagnosed based on the patient history and physical examination.
Bacterial sinusitis is usually treated with antibiotics. Early treatment of allergic sinusitis may prevent secondary bacterial sinus infections.
Home remedies for sinusitis and sinus infections include over-the-counter (OTC) medications such as acetaminophen (Tylenol and others), decongestants, and mucolytics. Nasal irrigation can be accomplished with a Neti-pot or rinse kit (nasal bidet).
Rare fungal infections of the sinuses (for example, zygomycosis) are medical emergencies.
Complications of a sinus infection that may develop are meningitis, brain abscess.