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Sinusitis: How to identify and deal with an infection

Recently, a 52-year-old woman visited Legacy Medical Group-Woodburn having suffered five days of congestion, yellow pus-like nasal discharge, headache, a productive cough in the morning that was worse at night, ear pressure, an occasional sore throat and swollen glands. She hadn’t been experiencing a fever but felt fairly run down.

What do you think is going on?

This patient likely has acute rhinosinusitis, also known as the common cold. Rhinosinusitis and sinusitis are used interchangeably. Viruses cause 90 to 98 percent of colds and sinus infections. You can have a fever with viral infections with symptoms peaking in the first week, followed by gradual improvement over the next 10 days.

It is very difficult to differentiate viral from bacterial infections. Early on, both bacterial and viral infections have the same symptoms. Most bacterial and viral rhinosinusitis resolves on its own, so not every case of bacterial infection requires antibiotics. If the symptoms of rhinosinusitis last longer than 10 days or the symptoms gradually get better then worse, it is most likely a bacterial infection. For those with less than 10 days of symptoms, observation without antibiotics is recommended. Symptomatic management includes: normal saline nasal spray or decongestant for the sinus congestion, Tylenol or Ibuprofen for pain, and Mucinex or cough syrup for cough or chest congestion. Rhinosinusitis can start out as a viral infection and progress to a bacterial infection which is why you should always follow up with your provider if symptoms worsen or fail to improve with symptomatic treatment.

Factors that make you more prone to sinusitis include a recent upper respiratory infection, allergies, nicotine or smoke exposure, pollution, deviated septum, dental problems, immune disorders, flying or rapid change in altitude and environmental changes. Good hand washing is definitely recommended when you have symptoms.

The two main germs involved in these infections are the same bugs that cause pneumonia and influenza, which is why we strongly recommend the influenza and pneumonia vaccines. These are especially important if you have chronic lung disease, diabetes, heart disease, kidney disease or an impaired immune system.

As we enter into the flu and cold season, remember to keep yourself healthy. Drink a lot of water, take your vitamins, get a lot of rest and most importantly, wash your hands regularly. If you do get sick and your symptoms worsen or continue longer than a few weeks, make sure to schedule an appointment with your doctor. Keeping yourself and those around you healthy will make for a much better holiday season!