by Erich Rosenberger M.D.

Created on: February 24, 2009

Sinusitis is an infection involving one or more of the sinuses in the head. The sinuses are spaces located just behind the face. There are four primary sinus cavities - the maxillary sinus, the ethmoid sinus, the sphenoid sinus, and lastly the frontal. All of the first three types have symmetrical counterparts on each side of the face.

The sinus cavities can become infected from time to time. Most of these infections will be bacterial in nature, although in less common cases, viruses and even fungi can infect a sinus cavity.

Sinusitis is broken in to two major sub-categories, acute sinusitis and chronic sinusitis. This article will focus on the more common of the two, acute sinusitis.

Acute sinusitis usually presents with pain over one side of the face. This pain can mimic a toothache if it involves the maxillary sinus, which is located near the side of the head and the ear. In fact, infections of the maxillary sinus can be caused by tooth infections which spread.

Infections to the sphenoid and frontal sinus will cause pain all over the head, and be more "centered". Pain, tenderness, runny nose with mucous, and sometimes swelling over the effected area, are all symptoms of acute sinusitis. Headaches and coughing are quite common as well.

How is sinusitis diagnosed?

Most doctors are able to diagnose acute sinusitis based on the appearance of the patient. It is possible to take x-rays of the sinus cavities, but this is not routinely done, as it has little effect on the ultimate outcome for the patient. CT scans are rarely done, and are usually reserved for cases where the symptoms may be mild and hard to identify.

Sinusitis is less common than minor viral infections, and many of the symptoms can mimic viral rhinitis (a cold). In the case of sinusitis, the problem is being caused by a bacteria. The most common bacteria which causes sinusitis is Strep pneumoniae. H. influenzae (not to be confused with true influenza viruses, this is a bacteria with a similar name), and even Staph aureus, can all cause sinusitis.

Being bactierial in nature, it is possible to treat sinusitis with commonly available antibiotics. If symptoms persist for more than a week, antibiotics are indicated. Severe cases with sharp pain and fevers will require more aggressive antibiotic treatments.

The antibiotic of choice for most cases of sinusitis is amoxicillin. Bactrim is sometimes used as well, depending on the doctor's and patient's preference. Degongestants can be used to help deal with some of the symptoms.

Most cases of sinusitis will resolve without long-term complications within a few weeks. Over 60% of people who do not recieve any treatment will clear the infection themselves within about two weeks. Antibiotics help to reduce that time and to lessen the changes of the bacteria spreading anywhere else.

If you think you have signs and symptoms of an acute sinusitis infection, make an appointment to see your doctor. This is a relatively easy problem to identify, and also relatively easy to treat. You'll be happy you got it taken care of.

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