Sinusitis and sinus infections

What is sinusitis?

The sinuses are the cavities in the bones around the nose and eyes, and in the forehead. Sinusitis is an inflammation of the lining of the sinuses. Inflammation causes swelling, nasal congestion and a blocked nose. Sinusitis is more common in children aged 4 to 7.

Sinuses

Signs and symptoms of sinusitis

Symptoms may include:

• sneezing
• nasal discharge
• daytime cough that can be worse at night
• facial pain
• headache

When sinusitis is associated with a viral respiratory infection, the symptoms usually improve on their own within 7 to 10 days. Fever may be present at the beginning of the viral infection but usually goes away after a few days.

Sinusitis caused by bacteria may improve on its own. Symptoms of bacterial sinusitis include:

• persistent cough and nasal discharge that last more than 10 days and are not improving
• fever that is persistent or that appears more severe than typically occurs with most viral infections
• children with a typical viral infection who initially get better and then worsen after 7 to 10 days
• headache that worsens when bending forward

Causes of sinusitis

Sinus infections almost always start from a viral respiratory infection. Over 90% of children with sinus infections have viral sinusitis. However, children with viral respiratory infections may develop bacterial sinusitis when bacteria grow within the sinuses. This is similar to how and why children can develop ear infections (otitis media).

If symptoms last longer than 10 days, symptoms start to improve and then worsen, or are very severe, the sinus infection could be getting worse and may be caused by bacteria. In this case, your child may need antibiotics.

What your child's health-care provider can do for your child with sinusitis

Physical examination

Your child's health-care provider will examine your child. Usually, reviewing signs and symptoms is enough to make a diagnosis and to identify the likely cause of sinusitis.

Investigations

X-rays do not help diagnose sinusitis in children. If a complication of a bacterial sinus infection is suspected, then your child may need a CT scan.

Treatment for sinusitis

There is no specific treatment for viral sinusitis. If your child is diagnosed with bacterial sinusitis and is started on antibiotics, they should start to improve within 48 to 72 hours.

Complications of sinusitis

Sometimes sinus infections can cause skin infections or spread into the area around the eye or into the bones of the face. Severe infections can also rarely spread to the brain. Symptoms of complicated bacterial sinusitis may include:

• swelling or redness of the skin, usually around one eye
• pain with eye movements or limited eye movements
• decreased vision
• persistent fever
• very severe headache
• photophobia (pain when looking at light)
• neck stiffness

How you can help your child

Ways to make your child feel better

Children can be given acetaminophen or ibuprofen for fever or headache.

When to get medical assistance

See a health-care provider if your child is showing symptoms of bacterial sinusitis.

See a health-care provider or visit the nearest Emergency Department right away if:

• your child has a high fever and a bad headache or neck stiffness
• your child has swelling around an eye, has a change in their vision or has trouble moving their eyes