Sinus Infection  

Sinus infection happens whenever virus, bacteria, or fungus, or any of the pathogen develops within the sinus thereby blocking the sinus ostium. Whenever the blockage is removed, mucus and pus are developed and drained from the nasal passages through the throat or the nostrils. A person suffering from sinus infection has inflammation of the sinuses and, as a result, discomfort is present as the openings of the sinuses are blocked. Inflammation occurs as an influx of immune cells and the sinuses’ tissues become swollen.

The paranasal sinuses or the air cavities within the nose become inflamed as a result of an infection caused by any of the pathogens cited above. This is commonly known as sinusitis. Most people also suffer sinusitis as a result of allergies or irritation of the tissues of sinuses.

Irritants like pollen from plants and that of the environment causes sinusitis with most people. This irritants affect the nasal passages such as with hay fever. Other irritants like chemicals and that of side-effects of over-the-counter (OTC) nasal sprays and illegal or controlled substances that goes through the nose may also cause sinusitis. It is estimated that about 30 million people suffer from sinusitis.

What is the sinus ?

There are hollow and air-filled cavities within the skull and connected to the nasal airway through a narrow hole in the bone, known as ostium, called sinuses. Humans have four pairs of such cavities, to wit:

• frontal sinus (located in forehead),
• maxillary sinus (located behind cheeks),
• ethmoid sinus (located between the eyes), and
• sphenoid sinus (located deep behind the ethmoids).

These four pairs of sinuses are collectively known as “paranasal sinuses.” The inner lining cells of each sinus are capable of secreting mucus, epithelial cells and in some aspect, part of the human immune system. The main function of the sinuses include humidifying of, and regulating the temperature of the air that is inhaled, insulating the tissues within the area like that of the eyes and nerves, increasing the quality of the voice or resonance thereof, and protection against facial trauma or injuries. With the sinuses, the weight of the skull is considerably reduced.

Facts about sinus infection

• Pathogenic microorganisms like viruses, bacteria and fungi causes sinusitis or infection of the sinuses. Such pathogens thrive and cause blockage of the sinus ostium.
• Sinus infections are not communicable, or cannot be transmitted between persons except in rare instances. They are caused by bacteria and fungi that thrive in the sinus tissue. The noticeable effects are swelling, inflammation, mucus secretion in an abnormal amount and facial or nasal trauma.
• Sinusitis may be caused by allergies from chemicals or other irritants which causes the inflammation of the air cavities in the nostrils.
• There are many ways to classify sinusitis. There are acute sinus infections, subacute sinus infections, chronic sinus infections, infected and noninfectious sinusitis.
• Symptoms of sinus infection include headache, tenderness in the face, pain in the sinuses, fever, discolored or cloudy mucus, stuffy nose, cough and sore throat.
• Facial pain, nasal discharge with pus, and discomfort which continue for more than a week and not relieved by over-the-counter medications.
• Diagnosis of sinus infection should be done by a medical practitioner taking into consideration the history of the patient and upon physical examination
• Antibiotics usually can treat sinusitis caused by bacteria
• Secondary bacterial sinus infection may be prevented when allergic sinusitis are treated at the onset of its symptoms
• Remedies and treatment of sinus infections include over-the-counter medications like Tylenol, mucolytics, and decongestants. Nasal bidet or rinse kit like Netipot can be used to irrigate the nasal cavities
• Fungal infections of the sinuses like zygomycoses is a medical emergency which should be attended with caution
• The complications that may be caused by the infection of the sinuses include meningitis, abscess in the brain, osteomyelitis and orbital cellulitis

Sinus Infection Symptoms

The symptoms of sinus infection vary depending on the severity and whether the infection is acute or chronic.

Acute sinusitis symptoms

Ethmoid sinusitis (located behind the eyes)

• Congestion of the nasal passage with nasal discharge
• Dripping of mucus down the throat from behind the nose or postnasal drip and sore throat
• Pain and pressure located at the inner corners of the eyes or down the nose
• Pain in the temple or that surrounding the eyes
• Pain and symptoms of pressure become rigid when straining, coughing or lying down, which is only alleviated when head is upright
• Fever is usually present

Maxillary sinusitis (located behind the cheek bones)

• There is usually pain in the cheekbone area, around and under the eye or upper teeth
• Pain in either or both sides of the cheekbone
• Maxilla or tenderness and swollen cheekbones
• Pain increases when head is upright and is relieved when head is reclined
• Postnasal drip
• Fever is usually present

Frontal sinusitis (located behind forehead, one or both sides)

• Headaches in the forehead which are severe in nature
• Fever is usually present
• Pain decreases when head is upright and is worsens when head is reclined
• Postnasal drip

Sphenoid sinusitis (located behind the eyes)

• Pain felt behind and on top of the head, across the forehead, behind the eyes
• Fever is usually present
• Postnasal drip
• Double vision or blurred eyesight especially when pressure and pain extends to the brain
• Pain decreases when head is upright and is worsens when head is reclined
• Worsening pain when lying or bending forward

Chronic sinusitis symptoms

Ethmoid sinusitis

• Recurring nasal discharge and discomfort, obstruction across the bridge of the nose
• Worsening pain in the morning and when wearing glasses
• Recurring bad breath, and sore throat

Maxillary sinusitis

• Tenderness and discomfort below the eye
• Recurring toothache and sensitivity of the teeth
• Worsening pain with colds, allergies, and flu
• Discomfort during the day and cough at night

Frontal sinusitis

• Persistent pain in the forehead area
• Recurring postnasal drip
• Damage to the sinus and trauma
• Sphenoid sinusitis
• Low-grade headache

Sinus Infection Diagnosis

Diagnosis of sinus infection is done by medical practitioner considering the history of the patient and after proper examination. X-ray of the area of the sinus may be misleading, CT and MRI scans are better options since these procedures are more sensitive in diagnosing such infection. The nasal secretions are also sent to laboratory tests in order to rule out the infectious and allergic sinusitis. Antibiotics are prescribed only with bacterial infections since antibiotics are not effective with viral infections.

Sinus Infection Treatment

No antibiotics is required in treating viral infections of sinuses. The most common and recommended treatment are medications for pain and fever like acetaminophen or commonly known Tylenol. Mucolytics and decongestants are effective for nasal discharge.

Symptoms of facial pain and pus-like nasal discharge which are present even after a week after taking over-the-counter medications may be associated with bacterial infection of sinuses. Antibiotics are effective for killing common bacterial that cause sinusitis like acute sinus infection.

The five most common bacteria which cause sinus infections are Streptococcus pneumoniae, Moraxella catarrhalis, Staphylococcus aureus, Haemophilus influenzae, and Streptococcus pyogenes. The antibiotics that should be administered must be able to eliminate all these five bacteria types. Amoxicillin (Amoxil) is usually administered, but Amoxicillin clavulanate (Augmentin) is more preferred as primary drug for treating suspected bacterial sinus infection as it is more effective in killing more species and strains of bacteria that causes sinusitis.

In draining sinus infection, mucolytics (guaifenesin), and decongestants (pseudoephedrine) may be administered orally.

In treating chronic forms of sinusitis, longer duration of medical treatment like Augmentin may be administered in draining sinus infection. This usually needs surgical operation in order to open the blocked sinus. In such operation, general anesthesia is required. Antihistamines must be prescribed with caution unless there is necessity as a result of allergy from irritants like pollen, dender, and other natural allergens.

Topical nasal steroid spray may be administered to swollen sinuses. The advantage of this is that drying is avoided which is usually the effect of antihistamines.

Most people develop first allergic sinusitis, then, later on, bacterial sinus infection. At the onset of allergic sinusitis, treatment is advised in order to prevent secondary bacterial infection.

A rare fungal sinus infection such as zygomycosis or mucormycosis occurs in debilitated patients which may cause death at a rate of 50% to 85%.

Home remedies for a sinus infection

There are home remedies which can be conveniently administered to treat sinus infections. Such remedies include the use of over-the-counter drugs like Tylenol, decongestants and mucolytics. In some cases, sinus rinse solution may provide relief against symptoms of sinus infections, or ever the most recurring sinus infections. Rinse kits such as Neti-Pot or sometimes called nasal bidet may be used. However, such procedure should be used properly in order to provide the desired relief.

In terms of bacterial and fungal sinus infections, antibiotics and antifungal medications are needed. Home remedies are not successful in treating these kinds of sinus infections even though the symptoms may be relieved.

Complications of Sinus Infection

Serious infections arising from sinus infections are not common. However, when there is a direct extension of infection to the brain through the walls of the sinuses, this will require medical emergency and often life-threatening as this may result in meningitis or abscess in the brain. Not only that the brain may be in danger but other areas as well such as osteomyelitis of the skull bones and eye infection or orbital cellulitis. This may cause death but very rarely. People with suppressed immune systems and those with multiple trauma injuries are the most susceptible to develop complications.

Prevention of Sinus Infection

How can sinus infection be prevented or avoided? In present time, no vaccines have yet been formulated or developed in order to fight infectious sinusitis. However, an indirect way to prevent sinusitis is to get vaccination against influenza and bacteria like pneumococci. Vaccinations against pathogens that causes sinusitis may be had but not proven to reduce the risk of getting sinusitis infection. In terms of fungal infection of the sinuses, no vaccine is effective against fighting it.

When a person suffers recurring sinusitis like yearly infections, he has to consider testing allergy testing. This may be allergic sinusitis which is recurring every time the person is exposed to. The treatment of allergy may be necessary in preventing secondary bacterial infections. Other conditions such as nasal polyps, tumors or diseases obstructing the normal flow of mucus may lead to sinusitis. In this regard, such conditions must be treated first to prevent recurring sinusitis infection.