Sinusitis

Sinus infections most commonly affect adults, but can happen to children and adolescents. Infants rarely get a sinus infection.

Between 6% and 7% of children who visit doctors seeking care for a respiratory condition have an acute sinus infection, according to the American Academy of Pediatrics.

The sinuses open into the nose and help control the temperature and water content of the air reaching the lungs. Sinuses are normally filled with air. When they become blocked and filled with fluid, then germs can grow and cause an infection (sinusitis).

A sinus infection can be either chronic or acute. 

Acute sinusitis:

• Sudden start of cold-like symptoms that do not go away after 10 to 14 days

Chronic sinusitis:

• Lasts more than 8 weeks or keeps coming back

Patients can be seen by Texas Children's experts in Ear Nose and Throat (Otolaryngology).

Causes & Risk Factors

Causes include:

• Bacteria
• Viruses
• Fungi

Risk factors include:

• Frequent upper respiratory infections
• Allergies
• Cystic fibrosis
• Compromised immune system

Symptoms & Types

Symptoms may include:

• A cough that doesn't get better after 7 days
• Fever
• Worsening congestion
• Headache
• Tooth pain
• Ear pain
• Tenderness in the face
• Nasal stuffiness and discharge
• Sore throat and postnasal drip
• Irritability
• Bad breath

Visit your primary care physician whenever your child has:

• A cold that lasts for more than 10 days without improvement
• Symptoms of allergies that don't clear with the usual allergy medication
• Pain in the face or ears

Diagnosis & Tests

Your doctor will determine whether the infection is viral or bacterial and chronic or acute through an examination.

The doctor will ask questions about symptoms and how long they have lasted. The doctor will feel and press on the sinuses for tenderness and may tap the teeth to see if that causes pain.

Tests may include:

• A mucus culture
• Nasal endoscopy (a tube-like instrument with tiny lights and cameras that examines the interior of the nose and sinuses)
• X-rays or CT scan
• Allergy testing
• Blood work

Treatment & Care

If the cause is bacteria, your child's doctor might prescribe oral antibiotics. If the cause is viral, antibiotics are not used.

Other treatments include:

• Saline nasal rinses
• Steroids
• Acetaminophen (Tylenol)
• Ibuprofen
• Warm compresses over the affected areas

Over-the-counter cold medicines have not been found to reduce symptoms and may cause unwanted side effects.

Patients with chronic sinusitis may be referred to an otolaryngologist to be evaluated for possible surgery.

Living & Managing

If your child is diagnosed with chronic sinusitis, you can take steps to lessen the symptoms and make episodes less painful.

These steps include:

• Making sure your child gets plenty of rest
• Having your child drink fluids such as water or juice. This helps to dilute mucous secretions and promote drainage
• Applying warm compresses to the face
• Asking the doctor about rinsing out nasal passages
• Asking the doctor about sleeping with the head elevated