Sinusitis Should not be Underestimated
The bones of the skull contain air-filled chambers (sinuses). The sinuses are four sets of hollow spaces that are located in the cheekbones, the forehead, behind the nasal passages, and deep in the brain. Sinuses are lined with the same mucous membranes that line the nose and mouth.
A sinus infection is a bacterial infection of one of the sinuses that normally drain into the nose. When someone has a cold or allergies and the nasal passages become swollen and make more mucus, so do the sinus tissues. The drainage system for the sinuses can get blocked, and mucus can become trapped in the sinuses. Bacteria, viruses, and fungi can grow there and lead to sinusitis.
Sinus congestion commonly occurs without an infection when one of the sinus openings becomes blocked from a cold or hay fever. Sinus congestion usually goes away on its own. If bacteria multiply within the sinus, a sinus infection can occur. The main symptom is facial pain. Other symptoms of a sinus infection are:
- swelling of the skin over the sinus
- fever that begins 3 or more days after your child gets a cold
- yellow/green nasal discharge lasting more than 10 days
Understanding the signs and symptoms of a sinus infection can help us know when we need to seek medical advice, however, the symptoms vary according to what sinuses are infected and if the infection is acute or chronic.
Younger kids often have cold-like symptoms, including a stuffy or runny nose and slight fever. If your child develops a fever 5-7 days after cold symptoms begin, it could signal sinusitis or another infection (like bronchitis, pneumonia, or an ear infection), so call your doctor.
Many parents mistake cold-related headaches in young kids for sinus infections. But the sinuses in the forehead don’t start developing until kids are 6 or 7 years old and aren’t formed enough to get infected until the early teen years, so headaches in kids who have colds usually aren’t sinus infections.
In older kids and teens, the most frequent symptoms of sinusitis are a daytime dry cough that doesn’t improve after the first 7 days of cold symptoms, fever, worsening congestion, dental pain, ear pain, or tenderness in the face. Sometimes teens who have sinusitis also develop upset stomachs, nausea, headaches, and pain behind the eyes.
The following treatment should reduce pain and fever within 48 hours or less.
- Antibiotics: This medicine will kill bacteria that are causing the sinus infection. Try not to forget any of the doses. If your child goes to school or to a baby sitter, arrange for someone to give the afternoon dose. If the medicine is a liquid, use a measuring spoon to make sure that you give the right amount. Even though your child will feel better in a few days, give the antibiotic until the bottle is empty to prevent the infection from flaring up again. Do not save the antibiotic for the next illness because it loses its strength.
- Nasal washes: Use warm water or saline nose drops followed by suction or nose blowing to wash dried mucus or pus out of the nose. Do nasal washes at least 4 times a day or whenever your child can’t breathe through the nose. If the air in your home is dry, run a humidifier.
- Decongestant nose drops or spray: To drain the sinuses, use a generic, long-acting decongestant nose drop or spray (such as oxymetazoline). You don’t need a prescription for the nose drops or spray. The usual dose for adolescents is 2 drops or sprays per nostril twice a day. For younger children use one drop or spray a day. Use the medicine routinely for the first 2 or 3 days of treatment. After that, don’t use the spray or nose drops unless the sinus congestion or pain recurs. Stop the drops or spray after 5 days to prevent rebound swelling.
- Pain-relief medicines: Your child can take acetaminophen (Tylenol) or ibuprofen (Advil) for a few days for sinus pain or any fever over 39°C (102°F).
- Oral antihistamines: If your child also has hay fever, she should take allergy medicine (antihistamine). Otherwise avoid using antihistamines because they can slow down the movement of secretions out of the sinuses.
- Contagiousness: Sinus infections are not contagious. Your child can return to school or day care when she is feeling better and the fever is gone.