What is acute sinusitis?
Acute sinusitis is inflammation of the nose and sinuses that usually lasts less than 4 weeks. Most cases are caused by a virus and get better without antibiotics. A smaller number are caused by bacteria and may need antibiotic treatment.
Common symptoms
- Nasal blockage or congestion.
- Thick or discolored nasal drainage.
- Facial pressure or pain.
- Reduced sense of smell.
- Sometimes fever, dental pressure, or symptoms that get worse again after first improving.
When could it be a bacterial sinus infection?
A bacterial sinus infection is more likely when symptoms are severe, last without improving, or get worse again after initially getting better.
How is it diagnosed?
Diagnosis is usually based on your symptoms, how long they have lasted, and an examination of the nose. A nasal endoscopy may be used when needed to look more closely inside the nose and the openings of the sinuses.
A CT scan is not usually needed for a simple episode of acute sinusitis. It may be considered if the diagnosis is unclear, a complication is suspected, or surgery is being considered.
Treatment
Treatment depends on the likely cause and how severe your symptoms are. Viral sinusitis usually improves with supportive care and topical nasal treatments such as saline irrigation or nasal sprays.
Antibiotics may be prescribed when a bacterial sinus infection is suspected. Oral steroids are not routinely needed and are only used in selected situations.
Recurrent Acute Sinusitis
What is it?
Recurrent acute sinusitis means having four or more separate acute sinus infections caused by bacteria within one year, with complete resolution of nasal and sinus symptoms between infections.
How is it managed?
Each acute bacterial sinus infection is treated appropriately. If infections keep happening, further evaluation may include nasal endoscopy, CT imaging, and checking for contributing problems such as nasal or sinus anatomy, allergies, or dental disease.
Sinus surgery may be considered when repeated infections continue despite appropriate medical treatment and there is a problem that can be improved with surgery.
Frequently asked questions
Is acute sinusitis the same as chronic sinusitis?
No. Acute sinusitis usually clears up within a few weeks, and you feel completely well afterward. Chronic sinusitis means symptoms last 12 weeks or more, or keep coming back without fully going away.