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Acute Sinusitis

Acute sinusitis is a condition where the sinuses are swollen and inflamed. The most common cause is a virus, though bacterial and fungal infections can occur. Acute sinusitis lasts less than four weeks.

The sinuses are pockets in the bones of the face. Along with the nasal passages, they help filter dirt, dust, bacteria, and any other pollutants from the air that a person breathes.

Symptoms

The symptoms of acute sinusitis can include:

  • Runny nose
  • Large amount of mucus coming from the nose
  • Stuffy or blocked nostrils
  • A general feeling of being unwell
  • Fever
  • Fatigue
  • Coughing
  • Sneezing
  • Headache
  • Pain of the cheekbones or forehead
  • Pain in the teeth

Causes

The most common cause of acute sinusitis is a virus. Some viruses which cause sinusitis can include rhinoviruses, coronaviruses, and other viruses which cause the common cold. Covid-19 and influenza can also cause viral sinusitis.

Less often, bacteria cause sinusitis. The most common scenario for this is a secondary bacterial infection. This is when a virus causes the original infection, but the pooled and trapped mucus becomes infected with bacteria in addition. A bacterial infection is more likely if symptoms do not go away in 10-14 days, or in people with severe pain and a high fever (over 39 C).

In very rare cases, immunocompromised people may have a fungal sinus infection. This may occur in people with untreated HIV/AIDs, people undergoing cancer treatment, people who have had an organ transplant, or people taking medicines to suppress the immune system.

Risk Factors

Certain people are at higher risk of acute sinusitis:

  • People with a history of environmental allergies or hay fever
  • People who smoke or live in a house where someone smokes
  • People who are immunocompromised
  • People whose noses aren’t anatomically correct (e.g., an injury to the nose has caused a nasal fracture so mucus can’t drain properly)
  • Babies younger than two or people older than 65
  • People with certain medical conditions, such as severe heart disease, lung disease, kidney disease, or liver disease

Diagnosis

Most of the time, if a person has viral sinusitis, there is no need to see a healthcare provider. The virus must run its course. If a person’s symptoms last for longer than ten days, or if they seem to get better and then become worse again, they should see their healthcare provider.

If a person has a high fever which does not respond to paracetamol or ibuprofen, becomes confused, notices a change in vision, sees redness or swelling around their eyes, or has a very stiff neck, they should seek advice from a healthcare professional right away.

Complications

Most cases of acute sinusitis clear up without complications.

In some cases, the problem can become recurrent (occur more than four times in a year), or chronic (symptoms lasting longer than 12 weeks).

In rare cases, the infection can progress beyond the sinuses into the brain, into the space around the eye, or into the bone itself.

Treatment

Most cases of acute sinusitis will go away on their own with time, rest, and plenty of fluids. A person may visit their local pharmacy to buy over-the-counter medications to help with symptom control.

For patients with a bacterial cause, antibiotics may be needed. For patients with a fungal cause, antifungals may be needed.

Prevention

To decrease the possibility of getting a virus, a person can wash their hands often with either soap and water or alcohol-based hand gel. If possible, a person should stay away from other people who are ill and not go to work when they are ill to avoid infecting others. Practicing good health by eating a diet which includes a wide range of fruits and vegetables, as well as getting eight hours of sleep every night can also help. For patients with HIV/AIDS, taking their medication exactly as prescribed can also help.

 
 
 

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