Complicated Sinusitis

June 12 23:27 2019 Print This Article

Sinusitis is an inflammation of the paranasal sinuses, which may or may not be as a result of infection, from bacterial, fungal, viral, allergic or autoimmune issues. The paranasal sinuses are air-filled cavities in the facial bones that open into the nasal passage through tiny holes called ostia. Sinusitis occurs when the sinuses become inflamed and the ostia become blocked. In acute uncomplicated sinusitis, symptoms last less than one month, and may be treated by a generalist physician.

Chronic sinusitis, defined as sinusitis of at least three months’ duration, requires the care of an ear, nose, and throat specialist. Acute sinusitis often occurs in the common cold and in the first ten days of symptoms there is reason to wait since things often improve on their own. In fact, a recent study suggests that treatment with a nasal steroid spray is as good as antibiotics in acute sinusitis. Beyond 10 days, it’s likely that things have evolved into a bacterial sinusitis.

Anyone can get a bacterial sinusitis but it’s more likely if you have allergies, smoke cigarettes have some certain anatomic variances within your sinuses or if you have an immune deficiency. Bacterial sinusitis can relapse and require more than one round of antibiotics.

Chronic sinusitis is potentially much more complicated than acute sinusitis depending upon the cause. Some patients with chronic sinusitis have localized areas of infection due to their sinus anatomy that might respond well to surgery alone. For others there is widespread swelling of the sinus membranes and though surgery may help some of these patients, they also need careful close monitoring and medications to keep the sinus swelling in check.

Causes of Complicated Sinusitis

Find common causes and risk factors of Complicated Sinusitis:

  • Haemophilus influenzae and Streptococcus pneumoniae are the organisms most commonly found in adults. In chronic sinusitis, the infecting organisms are variable, and a higher incidence of anaerobic organisms is seen (eg, Bacteroides, Peptostreptococcus, and Fusobacterium species).
  • In systemically impaired hosts, Candida, Aspergillus, and Phycomycetes may be the cause. Risk factors include the following: diabetes mellitus, cancer, hepatic disease, renal failure, burns, extreme malnutrition, and immunosuppressive diseases.
  • In children, similar organisms are seen, with the addition of Moraxella catarrhalis. In older children and young adults, Staphylococcus aureus is an occasional finding.

Signs and Symptoms of Complicated Sinusitis

Sign and symptoms may include the following:

  • Weakness.
  • Runny nose (rhinitis) or nasal congestion.
  • Fever.
  • Tiredness.

Treatment for Complicated Sinusitis

Treatment may include:

  • Avoiding triggers, such as cold air or allergens.
  • Pain medicine.
  • Increased oral fluids.
  • Corticosteroids.
  • Antibiotics.
  • Warm compresses on the face.
  • Saline nasal spray or rinses.