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Symptoms of sinusitis and how to differentiate each type

Symptoms of sinusitis, also called rhinosinusitis, occur when there is a sinus infection, which is an inflammation of the sinus mucus, these are structures that surround the nasal cavities. In this disease, there is often pain in the face, nasal secretion and headaches, although the symptoms may vary slightly according to the cause of the disease and the general health and sensitivity of each person.

In general, sinusitis is suspected when there are 2 or more of these symptoms:

  • Pain in the face region, especially in the regions of the cheekbones, around the nose and the eyes;
  • Headache or on the face that gets worse when lowering the head or lying down;
  • Nasal discharge and congestion, which may be white, yellowish or greenish;
  • Cough, especially at bedtime;
  • Fever above 38ºC;
  • Bad breath, which worsens as other symptoms become more intense.

In infants or young children, in order to know if they have sinusitis, you should be alert for the presence of nasal secretions accompanied by signs such as irritability, fever, drowsiness and difficulty in breastfeeding, even with foods they usually like.

Inflammation of the nasal sinuses during sinusitis
Inflammation of the nasal sinuses during sinusitis

How to differentiate each type of sinusitis

Sinusitis, is an inflammation that has many causes, such as:

1. Viral sinusitis

In about 80% of cases, viral sinusitis happens due to a simple cold, and it appears in people with symptoms of runny nose, usually transparent or yellowish, but also can turn greenish.

This type of sinus infection causes lighter or more bearable symptoms and, when there is fever, it does not usually pass 38ºC. In addition, viral sinusitis may be accompanied by other viral symptoms such as sore throat, conjunctivitis, sneezing, and blocked nose.

2. Allergic sinusitis

The symptoms of allergic sinusitis are similar to those of viral sinusitis. However, it happens in people who have had a recent crisis of allergic rhinitis, or who have been exposed to situations that usually cause sneezing and allergies in some people, such as a cold, dry environment, clothes or old books, for example.

It is common for people who have an allergy crisis to have an itchy nose and throat, frequent sneezing, and redness of the eyes.

3. Bacterial Sinusitis 

Bacterial sinusitis only occurs in 2% of the cases of this disease. It is usually suspected when there is fever above 38.5 ° C, severe pain on the face and purulent discharge from the nose and throat, or when symptoms, even if mild, persist for more than 10 days.

4. Fungal Sinusitis

Fungal sinusitis is frequent in people who have persistent sinus infections, which does not improve with treatment and with symptoms that drag on for a long time. In these cases, there may be a symptom only located in one region of the face, and usually does not cause other symptoms such as runny nose and fever.

Symptoms of sinusitis and how to differentiate each type

The physician after clinical evaluation and physical examination, differentiates the causes. However, as they are similar, it can be difficult to identify the exact cause.

There are also other rarer causes, such as tumors, polyps, strokes or chemical irritations, which should be suspected by the doctor in specific situations.

How is diagnosis reached

To diagnose sinusitis, it is only needed the clinical evaluation of a general practitioner or otorhinolaryngologist. Tests such as blood tests, X-rays, and CT scans are not necessary but may be helpful in some cases where there is doubt about the diagnosis or cause of sinusitis.

According to the duration of the infection, sinusitis can be divided into:

  • Acute, when it lasts up to 4 weeks;
  • Subacute, when it lasts between 4 and 12 weeks;
  • Chronic, when the duration is greater than 12 weeks, with micro-organisms resistant to the treatment, that can extend for several years.

Acute sinusitis is the most common type; however, subacute or chronic sinusitis can occur in people who have antibiotic-resistant bacteria, because of repeated or incorrect use of this medication, or after periods of hospital admission or surgery, for example.

Chronic sinusitis can also occur in people who are prone to accumulation of secretions in the sinuses, because of changes in the mucus of the area, or by certain diseases that may thicken the mucus, such as cystic fibrosis.

What to do in case of sinusitis

In the presence of symptoms that indicate sinusitis, which are accompanied by fever, purulent secretion in the nose, and intense pain on the face, one should seek a general practitioner or otorhinolaryngologist, who will recommend appropriate treatment for the disease.

Generally, if there are only cold symptoms or if the symptoms improve with home care in up to 7 to 10 days, it is recommended to use medications to relieve symptoms such as painkillers, anti-inflammatory drugs or corticosteroids, as it is probably a viral or allergic sinusitis. See some recipes of natural remedies for sinusitis that may help to alleviate the symptoms.

However, if the symptoms are severe, if fever is present, or if they do not improve within 10 days, antibiotics such as Amoxicillin may be needed.

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