Sinusitis
Also known as Rhinosinusitis, Sinus infection
This article is general health information for the selected condition. It is not a diagnosis and does not replace clinical judgement. If you have questions or need treatment advice, please consult a qualified healthcare professional.
What is sinusitis?
Sinusitis is inflammation of the lining of the paranasal sinuses, usually following a viral upper respiratory infection. Most acute cases are viral and resolve without antibiotics within two to three weeks. Bacterial infection is suggested by symptoms lasting beyond ten days or worsening after initial improvement.
Causes
- Viral upper respiratory infection
- Bacterial infection following viral illness
- Allergic rhinitis causing mucosal swelling
- Nasal polyps or deviated septum
- Dental infection spreading to the maxillary sinus
- Fungal infection in immunocompromised people
Symptoms
- Nasal congestion and blockage
- Thick nasal discharge
- Facial pain or pressure, worse on bending forward
- Reduced sense of smell
- Headache
- Postnasal drip and cough
- Fever in bacterial infection
- Toothache in the upper jaw
Risk factors
- Allergic rhinitis
- Asthma
- Nasal polyps or structural abnormality
- Smoking
- Immunodeficiency
- Frequent swimming or diving
Diagnosis
- Clinical diagnosis from symptom pattern and duration
- Nasal endoscopy for chronic or recurrent disease
- CT sinuses for chronic sinusitis or suspected complications
- Allergy testing where allergic rhinitis is suspected
- Urgent imaging if orbital or intracranial spread is suspected
Treatment
- Saline nasal irrigation
- Intranasal corticosteroid sprays
- Analgesia and decongestants for short term relief
- Antibiotics reserved for likely bacterial infection
- Treating underlying allergy
- Functional endoscopic sinus surgery for refractory chronic disease
Self care
- Use saline nasal irrigation, which is genuinely effective
- Use a steroid nasal spray with correct outward technique
- Apply warm compresses to the face
- Stay well hydrated and try steam inhalation
- Use paracetamol or ibuprofen for pain
- Sleep with the head slightly elevated
- Avoid prolonged decongestant spray use beyond a few days
When to see a doctor
Book an appointment if:
- Symptoms lasting more than ten days without improvement
- Symptoms improving then clearly worsening
- Recurrent episodes several times a year
- Symptoms lasting more than twelve weeks
- One sided blockage or bloody discharge
- Reduced sense of smell that is not recovering
Some symptoms need emergency care rather than an appointment. See the warning signs listed above.
Prevention
- Treat allergic rhinitis well
- Use saline rinses during colds
- Stop smoking and avoid second hand smoke
- Practise good hand hygiene
- Manage nasal polyps or structural problems
- Humidify dry indoor air
Outlook
Acute sinusitis resolves within two to three weeks in the large majority, usually without antibiotics. Chronic sinusitis is more persistent but responds to steroid sprays, saline irrigation and treatment of underlying allergy, with surgery reserved for refractory cases. Serious complications involving the eye or brain are rare but need emergency treatment.
Common questions
When are antibiotics appropriate?
Generally when symptoms persist beyond ten days without improvement, are severe with high fever and purulent discharge for three or more days, or worsen after an initial improvement. Most cases do not meet these criteria.
Does coloured mucus mean bacterial infection?
No. Green or yellow discharge is common in viral infection and reflects immune cell activity. Duration and pattern of symptoms are far more useful than colour.
What complications should prompt urgent care?
Swelling or redness around the eye, double vision, severe headache with neck stiffness, confusion or forehead swelling suggest spread beyond the sinuses and need emergency assessment.
References
Important: Dard AI is not a medical device and does not diagnose, treat, or replace clinician judgement. This article is general information only. Always consult a qualified healthcare professional about diagnosis and treatment, and seek emergency care for severe or rapidly worsening symptoms.