Acute sinusitis

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at April 26, 2016
StartDiseasesAcute sinusitis

Acute sinusitis is an inflammation of the nasal passages that is usually triggered by the common cold, but can also be caused by allergies, bacteria, and fungal infections. While this condition usually clears up on its own with home remedies and self-care, it can occasionally lead to complications or recur frequently and become chronic.


Definition & Facts

While sinusitis is a minor health issue compared to more serious illnesses, it hinders worker productivity and incurs high costs upon the health care system. Each year, acute and chronic sinusitis combine for a total of 37 million cases in the United States at a cost of more than $5.7 billion.

Symptoms & Complaints

Acute sinusitis causes swelling and inflammation of the nasal passages which interferes with mucus drainage and creates a feeling of irritation and congestion (ie: having a “stuffy nose”). People with acute sinusitis may experience difficulty breathing, throbbing facial pain, swelling in the area of the sinuses, or a sinus headache.

Additional symptoms include discharge that is thick green or yellow from the nose or into the throat; reduced sense of smell and taste; persistent cough; ear pain, mouth aches or jaw aches; bad breath; fever; and fatigue. Acute sinusitis is usually diagnosed when at least two of these symptoms are present in addition to yellow or green mucus drainage.

It is important to seek immediate medical attention if one develops signs of a serious infection, including pain or swelling around the eyes, stiff neck, vision changes, swollen forehead, severe headache, confusion, or shortness of breath. Left untreated, acute sinusitis can trigger an asthma attack among those with asthma as well as develop into chronic sinusitis, a condition in which symptoms last more than eight weeks and frequently recur. If a serious viral or bacterial infection is at work, it may spread to the lining of the brain, a condition called meningitis, or to the ears or eyes where it can cause hearing loss or vision loss


Most cases of acute sinusitis are caused by the common cold, which is a viral infection. If sinusitis symptoms last longer than a week, it most likely may be caused by a bacterial infection. In some cases, sinus abnormalities or a weakened immune system can make one susceptible to fungal infection that can cause inflamed sinuses.

Some groups are at higher risk for acute sinusitis. These include people who have hay fever or other allergies; nasal polyps or nasal tumors; a deviated nasal septum; an infected tooth; or chronic illness such as cystic fibrosis, gastroesophageal reflux disease (GERD), and autoimmune diseases.

A person is also more likely to develop sinusitis if he or she smokes or is frequently exposed to secondhand smoke. In very young children, additional sinusitis risk factors include exposure to other children at daycare or school, pacifier use, and frequently drinking a bottle while reclining.

Diagnosis & Tests

The health care professional will perform a thorough physical examination of the sinuses, ears, eyes, nose, and throat, as well as ask detailed questions about the patient's symptoms. He or she may administer medication that constricts the blood vessels in the nasal passages, which makes it easier to see inside in order to check for signs of infection and rule out other conditions, such as nasal polyps.

In some cases, a nasal endoscopy may be necessary. With this procedure, a thin probe with a light is inserted through the nasal passages so that the doctor can examine the inside of the sinuses. When abnormalities or complications are suspected, images tests such as CT scans or MRIs can also assist the doctor in making a diagnosis. Lab tests and allergy testing may be recommended to help pinpoint the underlying cause of acute sinusitis.

Treatment & Therapy

Acute sinusitis can usually be treated at home. One may find relief from symptoms by using nasal saline spray several times a day to rinse the sinus passages as well as with over the counter decongestants and pain relievers. In some cases, the doctor may prescribe nasal corticosteroids to help prevent and treat inflammation.

Important self care methods include getting enough rest; drinking plenty of fluids to help thin mucus and promote drainage, avoiding beverages with caffeine and alcohol; moistening the sinuses with a hot shower or by using a humidifier; applying warm compresses to her face; and sleeping with the head elevated to help the sinuses drain.

When home remedies don't relieve the sinusitis symptoms within a few days or symptoms worsen, the patient should see a doctor in order to avoid serious infection or other complications. He or she should avoid using over-the-counter medications for longer than recommended, since this can make symptoms worse over time. And if the sinusitis frequently recurs, that's another sign that medical treatment is necessary.

If the infection is bacterial in nature, a course of antibiotics may be prescribed. The patient should be sure to take the entire course as prescribed by the doctor, or the infection could recur or worsen. Antibiotics are not effective against viral infections though, so they will not be helpful in the majority of acute sinusitis cases.

In extreme cases of sinusitis, surgery may be necessary to remove blockages and allow the sinuses to drain. In many cases, this can be done with a minimally invasive procedure called balloon sinuplasty]]. With this procedure, which is similar to cardiac surgery using balloon angioplasty, a small balloon is inserted into the sinuses and inflated to unblock the clogged passages. Surgery may also be required to remove nasal polyps or correct other structural abnormalities. Another procedure, called a turbinectomy, shrinks swollen nasal passages to relieve symptoms.

Prevention & Prophylaxis

Because most cases of acute sinusitis stem from the common cold, avoiding germs during cold and flu season can help prevent this condition from developing. It is important to wash one's hands frequently and avoid those who are ill. If the patient has allergies, he or she should work with his or her doctor to help manage symptoms, which can help keep sinusitis from developing.

It is important to avoid or stop smoking and contact with secondhand smoke as well as other irritants and pollutants. In general, good health and hygiene habits will make one less susceptible to acute sinusitis and related conditions.