Nasal congestion and swelling, facial pressure, pain, fever, too much mucus. Ugh. It’s probably another sinus infection. Or is it? And is your infection caused by a virus or bacteria — and does it really matter?
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It does, says otolaryngologist Raj Sindwani, MD. Doctors treat viral and bacterial sinus infections very differently. Here’s what you need to know about both kinds of infections and how to treat them.
Viral or bacterial?
Sinusitis happens when your sinuses — the normally air-filled pockets in your face — become inflamed and blocked. Most sinus infections are viral. How can you tell whether your infection is viral or bacterial based on your symptoms?
“You can’t,” says Dr. Sindwani.
“Symptoms like bad breath, yellow or green mucus, fever and headache are not reliable signs of a bacterial infection,” he says. “They can occur with viral infections, too. Even your doctor can’t tell if your infection is viral or bacterial based solely on symptoms or an exam.”
Instead, your doctor looks largely at symptom duration to determine the source of your infection. A viral sinus infection will usually start to improve after five to seven days. A bacterial sinus infection will often persist for seven to 10 days or longer, and may actually worsen after seven days.
Some steps you can take
Whether your sinus infection turns out to be viral or bacterial, you can help to ease your symptoms early on with supportive sinus care:
- Use saline spray two to three times per day in each nostril.
- Use a nasal decongestant such as Afrin®, but not longer than three days.
- Drink eight 8-ounce glasses of fluid per day.
- Get plenty of rest.
- Take an over-the-counter anti-inflammatory, such as acetaminophen or ibuprofen to help relieve the swelling of your sinuses.
If your symptoms aren’t improving after one week, it’s important to see your doctor. If a bacterial infection is suspected, you’ll probably need to take an antibiotic to clear up the infection and prevent further complications.
“If your infections occur more frequently, and your doctor really wants to establish if they are bacterial or viral, your Otolaryngologist or ear, nose and throat doctor can sample the snot from your nose when you’re infected and send it to a laboratory to know for sure.
Note: Antibiotics won’t help a viral infection, and taking an antibiotic unnecessarily can do more harm than good. You risk possible side effects and increase your chances of developing antibiotic resistance, which can make future infections harder to treat, says Dr. Sindwani. So it’s important to wait and see how long your symptoms last.
What to do for chronic sinusitis
If you’re suffering from chronic sinusitis (nasal congestion, drainage, facial pain/pressure, and a decreased sense of smell lasting 12 weeks or longer) or you are getting frequent sinus infections you should see your doctor, says Dr. Sindwani.
Your doctor will swab your nose to collect mucus. Culturing it in a laboratory will reveal which type of bacteria is causing the infection so the right antibiotic can be prescribed.
Treat early sinus infection symptoms with rest, hydration and over-the-counter sprays and decongestants. But don’t look for an antibiotic unless your illness extends beyond a week, he says. Then check in with your doctor for a prescription and let him or her know if your condition worsens.
In the digital age, we are accustomed to getting what we want quickly. But some things, like sinus infections, take their time. Understanding the causes of these infections can help you be more realistic in your treatment plan.
Causes of Your Sinus
Infection
Nearly 31 million Americans get a sinus infection each year, according to the American College of Allergy, Asthma and Immunology.
The inflammation of the lining of your sinuses, the air-filled pockets in your face that sit around your nose, is caused by a viral or bacterial infection. A viral upper respiratory infection, also known as the common cold, or allergies can block your sinuses. This blockage promotes the development of a secondary infection.
You may have heard the urban legend that you can tell the cause of your sinus infection (bacterial or viral) by the color of your mucus. According to Dr. Donald Ford, a family medicine physician at the Cleveland Clinic, this is a myth.
“The green-yellow color of mucus that can develop is a byproduct of our own white blood cells, which we use to fight any kind of infection, viral or bacterial, so we can’t tell the cause from the color of the mucus,” he said. “When mucus is thick and dark it usually suggests some mild dehydration, and you should increase fluid intake and use lots of saline spray to keep the mucus thin.”
Sinusitis Symptoms
Many sinus infection symptoms are similar to that of the common cold. They include:
- Discolored mucus
- Post-nasal drainage
- Nasal congestion
- Facial pain/pressure
- Ear pain
- Tooth pain
- Sore throat
- Bad breath
How long these symptoms last depends on the type of sinus infection you are experiencing. Acute sinusitis generally lasts for four weeks or less, while chronic sinusitis can stretch for more than 12 weeks.
Typically, chronic sinusitis is exacerbated by environmental factors, including smoking and allergies. According to Dr. Ford, “Chronic sinusitis may have a number of causes, but the most common cause is allergies. Smoking causes impaired function of the cilia, part of the nasal membranes that remove mucus, and can contribute to developing chronic sinusitis.”
Sinus Infection Treatments
Your ear, nose and throat doctor recommends treating your sinus infection on your own. Start with nasal irrigation a few times a day and over-the-counter medication such as nasal steroid sprays and oral decongestants, if needed.
If you don’t find any relief after 10 days, contact your doctor. You may be prescribed a course of antibiotics.
For those with chronic sinusitis that does not respond well to medical treatment, surgery may be required.
To learn more about how to treat your sinus infection or to schedule an appointment with an ENT expert, contact Carolina Ear, Nose, Throat, Sinus & Allergy today.
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