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All About Sinusitis

Updated on October 22, 2011

That runny nose and cough just wont go away. Perhaps you have a sinus infection. Sinusitis is a common problem specially in children. Nevertheless, it is often over-diagnosed in children with green runny noses, and missed in children who really have a sinus infection!

What is it?

The sinuses are small empty caverns in the bony skull. They are lined by mucus membranes and connect with the nasal passages. Some sinuses are present at birth; others continue to grow and develop for the first 20 years of life. Sinusitis is the name given when the lining of one or more of these sinuses is red, swollen, and tender, the opening is blocked, and the sinus is at least partially filled with fluid (mucus and/or pus). Technically, every cold is also a case of viral sinusitis. However, when doctors use the term sinusitis they are usually referring to a bacterial infection in the sinuses.

There are three types of sinusitis: acute bacterial, sub-acute bacterial and chronic bacterial sinusitis. All have different treatments therefore the detection of its type is a must. However, the most common among them is the acute bacterial sinusitis.

Who gets it?

Anyone can get a sinus infection. Colds or nasal allergies are usually present first. Children who have ear infections, immune problems, etc. are more likely to develop sinus infections.

What are the symptoms?

Adults and adolescents with sinusitis will often have headaches or facial tenderness to make the diagnosis clear. These are much less common in younger children. Instead, the symptoms are usually similar to a prolonged cold. The common cold usually lasts about seven days but if a child has both a cough and nasal discharge that does not improve within 10 to 14 days, this may be acute bacterial sinusitis.

The nasal discharge may be clear or coloured. The cough is present during the day, but is often worse during naps or at bedtime. There may be a fever, sore throat or bad breath. About half of the children also have ear infections (caused by the same bacteria). Occasionally a child with severe bacterial sinusitis will have a headache, coloured nasal discharge, high fever, and facial tenderness well before the normal 10 days typically used to diagnose sinusitis.

In chronic sinusitis, the symptoms are often minimal, but include the ongoing cough and nasal discharge.

Is it contagious?

In general, sinus infections are not contagious (although there have been rare outbreaks associated with swimming together). The colds that can lead to sinus infections are quite contagious.

How long does it last?

Sinus infections often last for weeks or months without treatment.

How is it diagnosed?

The diagnosis is often made based on the history and physical examination. Sometimes x-rays or CT scans are used to support the diagnosis.

How is it treated?

Bacterial sinusitis is usually best treated with appropriate antibiotics at an appropriate dose for the appropriate amount of time (usually 14-21 days). The antibiotics are usually continued for at least 7 days after symptoms disappear. If symptoms worsen or do not improve, the antibiotic is usually changed early in the course. Saline nose drops may thin the mucus and speed healing.

How can it be prevented?

Preventing sinus infections is possible. It involves the same procedures recommended for preventing colds and ear infections.

In addition, changing swimming habits may be helpful for older children (avoiding jumping, diving, or swimming underwater unless holding the nose or using nose plugs).

Immunizations, specially for pneumonia, influenza, measles and flu are particularly important for children prone to sinus infections.

Finally, identifying and properly addressing allergies and irritants is the key to reducing the frequency, duration, and severity of sinusitis. But this does not mean you start self-medication for the disease. Please visit a doctor as soon as any of the symptoms of sinusitis arise.

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