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Acute Sinusitis | Doctors On Call | Your House Call Doctor

  • A stuffy nose and pressure on our cheekbones, near the eyes, or over the forehead may mean that you have Acute Sinusitis.
  • Acute sinusitis, also called Acute Rhinosinusitis, is a short-term inflammation of the membranes that line your nose and surrounding sinuses. This impedes your ability to drain mucus from your nose and sinuses.
  • Acute sinusitis is most commonly due to a cold causing viral infection. However, it can be due to non-infectious causes as well.
  • According to the American Academy of Otolaryngology, acute sinusitis is common. It affects around 1 in 8 adults per year.

What are the Symptoms of Acute Sinusitis?

  • Nasal congestion
  • Thick yellow or green mucus discharge from the nose
  • Sore throat
  • A cough, usually worse at night
  • Drainage of mucus in the back of your throat
  • Headache
  • Earache
  • Toothache
  • Bad Breath
  • Reduced Sense Of Smell
  • Reduced Sense Of Taste
  •  Fever
  • Fatigue

What Causes Acute Sinusitis?

Illnesses and conditions that can cause or lead to acute sinusitis include:

  • viruses
  • bacteria
  • fungi
  • intranasal allergies, such as hay fever
  • nasal polyps or other tumours
  • deviated nasal septum
  • infected adenoids
  • cystic fibrosis, an inherited genetic disease where thick, sticky mucus builds up in the body
  • An infected tooth could also cause acute sinusitis. In rare cases, bacteria can spread from the infected tooth to the sinuses.

Who’s at Risk for Acute Sinusitis?

The following factors can increase your risk of developing acute sinusitis:

  • intranasal allergies
  • nasal passage abnormalities, such as a deviated septum or nasal polyp
  • tobacco smoking or frequent breathing in of other pollutants
  • large or inflamed adenoids
  • spending a lot of time in a daycare, preschool, or other areas where infectious germs are frequently present
  • activities that result in pressure changes, such as flying and scuba diving
  • a weakened immune system
  • cystic fibrosis

Risk factors & Complications

You may be at increased risk of getting sinusitis if you have:

  • Hay fever or another allergic condition that affects your sinuses
  • A nasal passage abnormality, such as a deviated nasal septum, nasal polyps or tumours
  •  A medical condition such as cystic fibrosis or an immune system disorder such as HIV/AIDS

Acute sinusitis complications are uncommon. If they occur, they may include:

  • Chronic sinusitis. Acute sinusitis may be a flare-up of a long-term problem known as chronic sinusitis. Chronic sinusitis lasts longer than 12 weeks.
  • Meningitis. This infection causes inflammation of the membranes and fluid surrounding your brain and spinal cord.
  • Other infections. Uncommonly, infection can spread to the bones (osteomyelitis) or skin (cellulitis).
  • Partial or complete loss of sense of smell. Nasal obstruction and inflammation of the nerve for smell (olfactory nerve) can cause temporary or permanent loss of smell.
  • Vision problems. If infection spreads to your eye socket, it can cause reduced vision or even blindness that can be permanent.
  • Diagnosis

How is Acute Sinusitis Diagnosed?

  • Diagnosing acute sinusitis usually involves a physical examination
  • Your doctor will gently press over your sinuses with their fingers to identify an infection
  • The exam may involve looking into your nose with a light to identify inflammation, polyps, tumours, or other abnormalities

Other methods that might be used to diagnose acute sinusitis and rule out other conditions include:

  • Nasal endoscopy.  A thin, flexible tube (endoscope) with a fiber-optic light inserted through your nose allows your doctor to visually inspect the inside of your sinuses.
  • Imaging studies.  A CT scan or MRI can show details of your sinuses and nasal area.
  • While not recommended for uncomplicated acute sinusitis, imaging studies might help identify abnormalities or suspected complications.
    Nasal and sinus cultures.  Laboratory tests are generally unnecessary for diagnosing acute sinusitis.
  • However, when the condition fails to respond to treatment or is worsening, tissue cultures might help determine the cause, such as a bacterial infection.
    Allergy testing.  If your doctor suspects that allergies have triggered your acute sinusitis, he or she will recommend an allergy skin test.
  • A skin test is safe and quick, and can help pinpoint the allergen that’s responsible for your nasal flare-ups.

Treatments

Most cases of acute sinusitis, those caused by a viral infection, resolve on their own.  Self-care techniques are usually all you need to ease symptoms.

  Treatments to Relieve Symptoms

Your doctor may recommend treatments to help relieve sinusitis symptoms, including:

  • Saline nasal spray, which you spray into your nose several times a day to rinse your nasal passages.
  • Nasal corticosteroids. These nasal sprays help prevent and treat inflammation.
  • Examples include fluticasone (Flonase, Veramyst), budesonide (Rhinocort), mometasone (Nasonex) and beclomethasone (Beconase AQ, Qnasl, others).
  • Decongestants. These medications are available in over-the-counter (OTC) and prescription liquids, tablets and nasal sprays.
  • Use nasal decongestants for only a few days. Otherwise they may cause the return of more severe congestion (rebound congestion).
  • OTC pain relievers, such as aspirin, acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin IB, others).

Use caution when giving aspirin to children or teenagers. Children and teenagers recovering from chickenpox or flu-like symptoms should never take aspirin. This is because aspirin has been linked to Reye’s syndrome, a rare but potentially life-threatening condition, in such children.

Antibiotics

  • Antibiotics usually aren’t needed to treat acute sinusitis. Even if your acute sinusitis is bacterial, it may clear up without treatment.
  • Your doctor might wait and watch to see if your bacterial acute sinusitis worsens.
  • However, severe, progressive or persistent symptoms might require antibiotics.
  • If your doctor prescribes an antibiotic, be sure to take the whole course, even after your symptoms get better. If you stop taking them early, your symptoms may recur.

Immunotherapy

  • If allergies are contributing to your sinusitis, allergy shots (immunotherapy) that help reduce the body’s reaction to specific allergens may help treat your symptoms.
  • Surgery
  • In some cases, surgery may be necessary to treat the underlying cause of acute sinusitis. Surgery may be performed to:
    • remove nasal polyps or tumours
    • correct a deviated nasal septum
    • clean and drain your sinuses

Lifestyle and Home Remedies
These self-help steps can help relieve sinusitis symptoms:

  • Rest. This will help your body fight infection and speed recovery.
  • Drink fluids, such as water or juice. This will help dilute mucous secretions and promote drainage.
  • Avoid beverages that contain caffeine or alcohol, as they can be dehydrating.
  • Drinking alcohol can also worsen the swelling of the lining of the sinuses and nose.
  • Moisten your sinus cavities. Drape a towel over your head as you breathe in the vapor from a bowl of hot water.
  • Keep the vapour directed toward your face.
  • Or take a hot shower, breathing in the warm, moist air. This will help ease pain and help mucus drain.
  • Apply warm compresses to your face. Place warm, damp towels around your nose, cheeks and eyes to ease facial pain.
  • Rinse your nasal passages. Use a specially designed squeeze bottle (Sinus Rinse, others) or neti pot. The home remedy, called nasal lavage, can help clear your sinuses.
  • If you make your own rinse, use water that’s contaminant-free — distilled, sterile, previously boiled and cooled, or filtered using a filter with an absolute pore size of 1 micron or smaller — to make up the irrigation solution.
  • Also be sure to rinse the irrigation device after each use with contaminant-free water and leave open to air-dry
  • Sleep with your head elevated. This will help your sinuses drain, reducing congestion.

Prevention of Acute Sinusitis

Take these steps to help reduce your risk of getting acute sinusitis:

  • Avoid upper respiratory infections. 
    • Minimize contact with people who have colds.
    • Wash your hands frequently with soap and water, especially before your meals.
  • Manage your allergies.
    • Work with your doctor to keep symptoms under control.
    • Avoid cigarette smoke and polluted air.
    • Tobacco smoke and other pollutants can irritate and inflame your lungs and nasal passages.
  • Use a humidifier. 
    • If the air in your home is dry, such as it is if you have forced-air heat, adding moisture to the air may help prevent sinusitis.
    • Be sure the humidifier stays clean and free of mould with regular, thorough cleaning.

What Happens in the Long Term?

  • Most cases of acute sinusitis clear up with home treatment.
  • Sometimes acute sinusitis doesn’t clear up and becomes sub acute or chronic sinusitis.
  • Sub acute sinusitis can last four to eight weeks in duration.
  • Chronic sinusitis can last over eight weeks.
  • In very rare cases, acute infectious sinusitis can lead to an infection that spreads to your eyes, ears, or bones.  It could also cause meningitis.

Call a Doctor, such as Doctors-on-Call  if You Experience:

  • Symptoms that either don’t improve within a few days or worsen
  •  A persistent high-grade fever
  • A severe headache that doesn’t respond to medication
  • Vision changes
  • A history of recurrent or chronic sinusitis

These may be signs that the acute infection has spread outside your sinuses

Preparing for Your Appointment

When you see your doctor, expect a thorough examination of your sinuses. Here’s information to help you get ready for your appointment.

Make a list of:

  • Your symptoms, including any that seem unrelated to the reason for your appointment
  • Key personal information, including whether you have allergies or asthma and family medical history
  • All medications, vitamins or other supplements you take, including the doses
  • For acute sinusitis, questions to ask your doctor include:
  • What’s likely causing my symptoms?
  • What are other possible causes for my symptoms?
  • What tests do I need?
  • Is my condition likely temporary or chronic?
  • What’s the best course of action?
  • What are the alternatives to the primary approach you’re suggesting?
  • I have these other health conditions. How can I best manage them together?
  • Are there restrictions I need to follow?
  • Should I see a specialist?

Doctors-on-Call, your house-call-doctor service, are able to advise & assist you with the treatment of acute or chronic Sinusitis

It is a good idea to have a ‘house call doctor’ like Doctors-on-Call  number at hand, if you or anyone in your family are suffering from some of the more severe & painful sinus related symptoms. Doctors-on-Call service the Sandton, Rosebank, Melrose Arch areas in Johannesburg and the hotel and business district in Cape Town.

It is especially important to contact Doctors-on-Call if symptoms do not clear after a few days or take a turn for the worse.

Timeous and effective treatment of Sinusitis is crucial to ensure the appropriate relief and precautionary measures are taken to lower the likelihood of serious complications.  Treatment also includes a discussion of risk factors, preventative measures & possible lifestyle changes.

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