Sinus infection

Also known as: Pokenga pakohu ihu, Acute sinusitis, Viral sinusitis, Rhinosinusitis, Bacterial rhinosinusitis

• Sinus infections or sinusitis occurs when the sinuses become inflamed or infected.
  
• Usually sinus infections develop after a person has had a common cold, or a bout of allergies like hay fever.
  
• Normally sinus infections just need to run their course. Most people will recover without any medication after 1–2 weeks.
  
• Over-the-counter decongestants and pain relief may make a person more comfortable while their body fights off the infection.

• Sinuses are air spaces in your skull that sit around your nose, forehead and cheeks. They make mucus, which naturally drains out of your nose.
  
• When people get hay fever or a cold, they can get an infection in their upper airways. This causes inflammation and/or an infection to occur in the lining of their sinuses.
  
• Most sinusitis is caused by viral infection. Only 0.5–2% of sinus infections are bacterial or fungal.
  

Some people are more prone to sinus infections than others. Things that can put you more at risk of developing sinusitis include:

• Upper respiratory airways infection (eg: a cold or flu)
• Allergy and related conditions (eg: asthma, hay fever)
• Dental infection
• Cystic fibrosis
• Weakened immune system (eg: due to chemotherapy)
• Smoking and other air pollutants.

Seasonal

Sinusitis can develop when a person has hay fever or a cold, so infections may be more common during cold and flu season, or during spring when there is a lot of pollen in the air.

In adults

• Headaches  with the pain focused around the front of the head
• A “heavy” or “full” feeling around the nose, forehead, cheeks and eyes – this usually gets worse when tilting forward
• Increased pressure or tenderness around the sinuses
• A blocked or runny nose
• Post-nasal drip – this is what it’s called when mucus drips down the back of the throat
• A decreased sense of smell and taste
• Smelly breath
• A high temperature
• Fatigue
• Sore teeth
• Coughing
• Increased pressure in the ears

Chronic and acute sinusitis have similar signs and symptoms – the key distinction between them is their length of time you have the symptoms. Chronic sinusitis is ongoing symptoms for more than three months.

Diagnosis

Your doctor can usually diagnose acute sinusitis from the symptoms you describe. They may also check to see if you have a temperature or if you have tenderness around your sinuses.

In children

Symptoms in kids differ slightly from adults. Things to look out for include:

• Having a fever
• Being restless or irritable
• Snoring
• Breathing through their mouth
• Having sore ears
• Smelly breath
• Coughing
• Sounding nasal when they speak

In adults

• Pressing a heat pack to the affected areas can also provide some relief
• Paracetamol or ibuprofen can be used to help relieve pain.
  

• Antihistamines may help if the sinus infection has been caused by allergies.
  
• Decongestant nasal sprays like oxymetazoline can help to relieve congestion, but it’s important to read the label or ask the pharmacist about dosage. Overuse can actually lead to more congestion.
  
• Decongestant tablets like phenylephrine may be helpful for particularly stubborn blocked noses. Some decongestant tablets are available over-the-counter, while others will need to be prescribed by a doctor.
  
• Steroid nasal sprays like Flixonase may also help to relieve blocked sinuses.
  
• Antibiotics are seldom needed to treat sinusitis because sinusitis is mostly caused by viruses (a viral infection). Antibiotics only work against bacteria (a bacterial infection) but not viruses. Antibiotics are considered when symptoms last longer than 10 days, start to improve but then worsen again, or are very severe such as a fever over 39°C, extreme pain and tenderness over your sinuses, or signs of a skin infection, such as a hot, red rash that spreads quickly.
• If you are given antibiotics, finish the full course.

In children

• Most kids will get better without the need for medication. As with adults, rest, hydration, heat packs and saline sprays should do the trick.
  
• However, complications are more likely to occur in children than in adults. Swollen or red cheeks and/or eyelids could indicate the infection has spread. If this happens, the child should see a doctor immediately.
  
• While rare, in very severe or very persistent cases, a child may need surgery to open up their pathways a bit and allow mucus to drain more easily. Removing the child’s adenoids may also be necessary.

Medication

• Most sinus infections are caused by a virus, which antibiotics won’t help with.
  
• On the rare occasion that a sinus infection is bacterial, antibiotics may be used to help treat it.

Home Remedies

Saline nasal sprays or sinus rinses can help with congestion. The saline solution can be made at home while the rinse bottle can be bought from a pharmacy.

To make the saline solution, simply dissolve the following in 250ml of warm water:

• ¼ tsp baking soda
• ½  tsp non-iodised salt

Proactive protection

• If you’re a smoker, quitting should make you less susceptible to sinus infections. Avoiding second-hand smoke is a good idea too.
  
• Practice good hand hygiene to avoid catching a cold, which could turn into a sinus infection.
  
• Avoid kissing or sharing food and drinks with people who have recently had a cold.

• f your symptoms haven’t improved after 2 weeks, you should see a doctor.
  
• If your child has red or swollen eye-lids or cheeks, this could indicate a more serious infection. If this happens, they should see a doctor immediately.

Which specialist should I visit?

Ear, nose and throat doctor

• Most patients recover from a common sinus infection after 1–2 weeks.

• Chronic sinusitis, which is a more severe sinus infection, can last for 3 months or longer.