Sinusitis

Signs and Symptoms:
The sinuses are moist air spaces found in the facial bones around the nose, including areas within the cheek bones and in the bones of the forehead above the eyes. When these sinus spaces become infected, the infection is called sinusitis. Sinusitis can be either acute (symptoms present for less than one month), subacute (symptoms for 1-4 months), or chronic (symptoms for more than four months).

Acute sinusitis may cause different symptoms in different age groups. In adults and older children, for example, symptoms include: a stuffy nose; a discharge from the nose that is yellow, green, bad-smelling or tinged with blood; redness inside the nose; swelling or dull pain around the eyes; tenderness in the area of the cheeks or around the eyes; cheek pain that may be mistaken for a toothache; a feeling of "pressure" in the head; a morning headache; a headache that gets worse when the child bends forward; and bad breath. Sometimes there may also be a dry cough or a low-grade fever, and the child may have trouble sleeping. Stomach upset with vomiting of mucus may be present.

Younger children may have any of the symptoms listed above, but sometimes their complaints are less specific. They may appear to have a "common cold" (stuffy nose, runny nose, low fever) that continues for 10 days or more, or their "cold" may make them look sicker than usual, with a high fever and a discolored discharge from the nose. In a child with allergies, sinusitis may appear as a stuffy or runny nose that doesn't improve with the usual doses of allergy medication.

Children with subacute sinusitis or chronic sinusitis have symptoms that last for more than one month. They may have any of the following symptoms: an abnormally-colored nasal discharge; stuffy nose; redness inside the nose; cough (especially at night); snoring; and trouble sleeping. They are less likely to have fever than children with acute sinusitis.

Description:
Sinusitis is an infection of the sinus air spaces found in the facial bones around the nose. Sinusitis can be caused by bacteria, viruses, or a mixture of these disease-producing germs. When sinusitis is caused by a bacterial infection, the most likely culprits include MORAXELLA CATARRHALIS (bacteria normally found in the upper respiratory tract and one of the species of STREPTOCOCCUS bacteria). Common viruses that can also cause sinusitis include: rhinovirus; and parainfluenza virus (a common cause of croup).

Prevention:
You can make some simple changes in your lifestyle or home environment that may help lower your child's risk for sinusitis. For example, in winter months, when the cold air outside and your heating system make the air inside your home abnormally dry, use a humidifier to keep home humidity at 45% to 50%. This will stop dry air from irritating the sinuses, and make them less of a target for infection. (Don't forget to clean your humidifier as directed to avoid growth of mold). During summer months, encourage children to keep their heads above water when they play in swimming pools and to avoid deep dives and somersaults under water. If you smoke, quit. Allergy management at all times of the year is important in the allergic child.

Incubation:
The incubation period for sinusitis varies depending on the specific type of bacteria or virus that causes the illness.

Duration:
Most children with acute sinusitis either recover spontaneously, or with antibiotic medication, within 2-3 weeks. Even chronic sinusitis usually can be cured after three weeks of antibiotic treatment.

Contagiousness:
Sinusitis is not contagious, however, the cold that frequently precedes sinusitis may be spread to other family members.

Home Treatment:
If your doctor prescribes antibiotics to treat your child's sinusitis, give these medications on schedule for as many days as your doctor directs. This will help to kill all of the bacteria causing the sinusitis, and will prevent them from growing again (and causing another episode of sinusitis) when the prescription is finished.

Use a cool-mist humidifier to soothe your child's sinuses with cool moist air. If your child is having facial pain in the sinus area, use warm compresses to relieve discomfort. If your doctor approves, use nose drops to help open stuffy nasal passages.

Professional Treatment:
Sinusitis is treated with antibiotics, given by mouth, for as long as three weeks. Some doctors also prescribe decongestants. Antihistamines may be useful in the allergic patient.

When To Call Your Pediatrician:
Call your doctor whenever your child has a "cold" that lasts for more than 10 days, or for symptoms of "allergies" that don't clear with the usual allergy medication. Call your doctor for any of the signs or symptoms of sinusitis, including: pain or stuffiness in the cheeks or around the eyes; a contining discharge from the nose that is yellow, green, bad-smelling, or tinged with blood; a headache that either is worse in the morning or gets worse when your child bends forward.