- Main symptoms of acute sinusitis
- How to know if it is acute or chronic sinusitis
- How to confirm the diagnosis
Acute sinusitis, or acute rhinosinusitis, is an inflammation of the mucosa that lines the sinuses, structures that are around the nasal cavities. Most of the time, it happens due to a viral or allergic infection, due to allergic rhinitis crisis, and only in some cases there is bacterial infection, but it can be difficult to differentiate the causes, as they all cause similar symptoms such as cough, pain in the face and nasal discharge. Learn how to identify symptoms and differentiate the types of sinusitis.
To be classified as acute sinusitis, the inflammation must last a maximum of 4 weeks, and its symptoms must improve naturally or with the treatment prescribed by the general practitioner or ENT. When it is not treated, or when it occurs by resistant microorganisms or associated with weakened immunity, for example, it can progress to subacute sinusitis, which lasts up to 3 months, or chronic sinusitis, with symptoms that persist and exceed 3 months.
Main symptoms of acute sinusitis
The most common symptoms that usually arise in the setting of acute sinusitis are:
- Nasal or facial pain, usually in the inflamed sinus region, which is worse in the morning; Headache, which gets worse when lying down or lowering the head; Nasal obstruction and discharge, usually yellowish or greenish; Cough that gets worse at bedtime; Fever of around 38ºC, is present in half of the cases; Bad breath.
Often, it can be difficult to differentiate, just by the symptoms, the cause of acute sinusitis, but, in most cases, it is caused by a cold or an outbreak of allergic rhinitis, which can also cause symptoms such as sore throat, conjunctivitis and sneezing.
How to know if it is acute or chronic sinusitis
Acute sinusitis happens most of the time, however, in some cases, it can become chronic sinusitis. To differentiate between these situations, one must be aware of the following details that may vary, such as:
| Acute Sinusitis | Chronic Sinusitis | |
| Duration | Up to 4 weeks | More than 3 months |
| Cause | Virus infections, allergic rhinitis crisis or bacteria like S. pneumoniae , H. influenzae and M catarrhalis . |
It usually arises from acute sinusitis that has not been treated correctly. Because it is caused by more resistant bacteria, or by different types of acute infection, such as Prevotella, Peptostreptococcus and Fusobacterium ssp, Streptococcus sp and Staphylococcus aureus , or by fungi and persistent allergy. |
| Symptoms | They are more intense and sudden symptoms. There may be fever, pain in several sinuses. | There may be pain located in 1 sinus of the face, or just a feeling of pressure on the face, instead of pain. |
Sinusitis can also be recurrent, that is, there are cases of acute sinusitis that are repeated 3 times in a period of 6 months or 4 times in the course of 1 year, which usually happens in people with weakened immunity or who have recurrent attacks of allergic rhinitis.
How to confirm the diagnosis
The diagnosis of sinusitis is clinical, that is, made only with medical evaluation and physical examination. Only in some cases of doubt, or in cases of chronic sinusitis, to better determine the cause, the doctor may order some tests such as x-rays, computed tomography of the face or nasal endoscopy.
After confirming the cause, the doctor should guide the recommended treatment, usually with anti-inflammatories, nasal or oral decongestants and general measures such as staying well hydrated throughout the day, nebulization and nasal washing with saline solution.
The use of antibiotics is recommended only when bacterial infection is suspected, and, in more severe and chronic cases, drainage of accumulated secretion may be necessary. Find out more details about how sinusitis is treated.
