What you need to know about acute sinusitis

What you need to know about acute sinusitis

Picture: iStock

If your doctor suspects that allergies have triggered your acute sinusitis, he or she will recommend an allergy skin test.

Acute sinusitis is when the cavities around your nasal passages become inflamed and swollen. This leads to mucus build-up and interferes with drainage.

This makes it difficult to breathe through your nose. The area around your eyes and face might feel swollen and you might have throbbing facial pain or a headache.

Acute sinusitis is mostly caused by the common cold, which is a viral infection. In some cases, a bacterial infection develops.

Most cases resolve spontaneously within a week to 10 days, unless a bacterial infection develops. In most cases, home remedies are all that’s needed to treat it.  However, persistent sinusitis can lead to serious infections and other complications.

Most people with acute sinusitis don’t need to see a doctor. Contact your doctor if you have any of the following:

  • Symptoms that either don’t improve within a few days or worsen.
  • A persistent fever.
  • A history of recurrent or chronic sinusitis.


Acute sinusitis symptoms often include:

  • Drainage of a thick, yellow or greenish discharge from the nose or down the back of the throat (postnasal drainage).
  • Nasal obstruction or congestion, causing difficulty breathing through your nose.
  • Pain, tenderness, swelling and pressure around your eyes, cheeks, nose or forehead that worsens when bending over.

Other signs and symptoms can include:

  • Ear pressure.
  • Headache.
  • Aching in upper jaw and teeth.
  • Reduced sense of smell and taste.
  • Cough, which might be worse at night.
  • Bad breath (halitosis).
  • Fatigue.
  • Fever.

The following signs or symptoms may indicate a serious infection:

  • Pain, swelling or redness around your eyes.
  • Swollen forehead.
  • Severe, unrelenting headache.
  • High fever.
  • Confusion.
  • Double vision or other vision changes.
  • Stiff neck.

Risk factors

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 might 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.


Consult your doctor who will do a history and physical examination which includes feeling for tenderness in your nose and face and looking inside your nose.

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.


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.

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 (Flixonase), budesonide (Rhinocort), mometasone (Nasonex) and beclomethasone (Beconase).

• Decongestants. These medications are available in over-thecounter 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)

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