Acute Sinusitis: Symptoms, Causes, Treatment, and Prevention

What Is Acute Sinusitis?

Inflammation of the paranasal sinuses (air-filled cavities in the facial bones) lasting <4 weeks, usually triggered by viral infection, allergies, or irritants.

Symptoms

• Nasal congestion/obstruction
• Facial pain/pressure (forehead, cheeks, between eyes)
• Thick nasal discharge (yellow/green)
• Reduced/loss of smell (hyposmia/anosmia)
• Headache (often frontal)
• Postnasal drip, sore throat, cough
• Fever (more common in bacterial cases)
• Fatigue, bad breath

Causes

• Viral URI (common cold): 90–98% of cases; resolves in 7–10 days.
• Bacterial superinfection: Suspect if symptoms >10 days, worsening after initial improvement ("double sickening"), high fever, severe pain.
• Allergic rhinitis: Chronic inflammation predisposes to sinusitis.
• Anatomic factors: Deviated septum, nasal polyps, narrow sinus ostia.
• Environmental: Smoke, pollution, dry air, pressure changes.

Treatment

• Symptomatic (viral): Saline irrigation, intranasal corticosteroids, decongestants (short-term), analgesics, hydration, steam.
• Antibiotics: Reserved for confirmed/suspected bacterial cases (e.g., amoxicillin/clavulanate 5–7 days).
• Adjuncts: Mucolytics, antihistamines if allergic component.

When to See a Doctor

• Symptoms >10 days without improvement
• Severe symptoms (high fever, severe headache, visual changes, periorbital swelling)
• Recurrent episodes (≥4/year)
• Immunocompromised

Prevention

• Hand hygiene, avoid sick contacts
• Manage allergies
• Humidify dry air
• Avoid smoke
• Annual flu vaccine