Acute Sinusitis

Your sinuses are the air-filled hollow cavities around your nose and nasal passages. When these passages become inflamed, fluid may accumulate and interfere with normal drainage of mucus in the sinuses. This condition is known as acute sinusitis.

The result? You may have trouble breathing through your nose. When you lean forward, throbbing pains may move across your face. You may have a headache, fever or nagging cough, and you feel your eyes and facial tissue swell up.

It's an uncomfortable condition. The common cold virus is the most frequent cause, although other triggers include bacteria or allergies. Most colds resolve with time, but nearly 2 percent develop into acute sinusitis. Almost 40 million Americans experience sinusitis each year, at an annual health care cost of nearly $6 billion.

Treatment of acute sinusitis depends on the cause, and therapies can range from antibiotics for bacterial cases to oral corticosteroids for acute inflammation.

Untreated acute sinusitis can lead to more-serious infections or become a chronic condition. However, most cases are short-lived. When symptoms last less than four weeks, the sinusitis is considered acute.

Signs and symptoms of acute sinusitis may include:

• Facial pain
• Fever
• Pain, tenderness and swelling around your eyes, cheeks, nose or forehead
• Erythema, or redness of the skin over the sinus caused by increased blood flow to the capillaries
• Nasal congestion
• Difficulty breathing through your nose
• Reduced sense of smell or taste
• Dental pain
• Cough
• Bad breath (halitosis)
• Fatigue
• Nausea
• Sore throat

Sinusitis develops when the mucous membranes of your upper respiratory tract — the nose, pharynx, sinuses and throat — become inflamed. The swelling obstructs the sinus openings and prevents mucus from draining normally. This creates a moist environment conducive to infection.

The cause of sinusitis is most often viral, such as the common cold virus, but the cause can also be bacterial or fungal. When an upper respiratory tract infection persists longer than 14 days, it's more likely a bacterial cause than a viral cause.

There also are noninfectious triggers of acute sinusitis, including:

• Allergies. Inflammation that occurs with allergies may block your sinuses.
• Deviated nasal septum. A crooked septum — the wall between the nostrils — may restrict or block sinus passages.
• Nasal polyps. These tissue growths may restrict the nasal passages.
• Other medical conditions. The complications of cystic fibrosis, gastroesophageal reflux, or HIV and other immunodeficiency diseases may result in nasal blockage.

The blockages associated with sinusitis can worsen if you smoke or are exposed to air pollution, both of which can cause further irritation or inflammation.

If untreated, acute sinusitis may develop into a chronic condition. Chronic sinusitis, by definition, lasts longer than eight weeks. Complications of acute sinusitis include:

• Acute Asthma. Acute sinusitis can trigger an asthma exacerbation.
• Meningitis. The infection spreads to the lining of the brain.
• Vision problems. Reduced vision or blindness if the infection spreads to your eye socket.
• Aneurysms or blood clots. Infection can cause problems in the veins surrounding the sinuses, interfering with blood supply to your brain.

Many cases of sinusitis will subside without the need for antibiotics. Self-care techniques may speed along recovery.

If your doctor suspects you have a bacterial infection, he or she may prescribe a course of antibiotics such as amoxicillin (Amoxil, Trimox), doxycycline (Doryx, Monodox) or the combination drug trimethoprim-sulfamethoxazole (Bactrim, Septra). If the infection doesn't subside or if the sinusitis is recurrent, a different antibiotic may be warranted.

Your doctor may also recommend other treatment methods, depending on the underlying cause of the sinusitis. These include:

• Treating an underlying allergic condition that contributes to sinusitis
• Using prescription decongestants, nasal corticosteroid spray or oral corticosteroid pills to relieve stuffiness
• Taking over-the-counter decongestants or pain relievers
• Spraying a saline solution in your nose several times a day