Sinus Infection Tips from Pediatric Partners

SINUS INFECTION SYMPTOMS

• Pain or pressure on one side of the face
• Swelling around just one eye
• Stuffy or blocked nose or nasal discharge.
• Nasal drip down the back of the throat (postnasal drip).
• Less common symptoms are
  • bad breath
  • mouth breathing
  • sore throat
  • throat clearing from postnasal drip.

CAUSES OF SINUS CONGESTION

• Viral Sinus Infection.
  • Also known as the common cold.
  • A cold infects the lining of the nose and involves the lining of all the sinuses.
  • Drainage can be clear, yellow, or green. Color can change during the course of an upper respiratory infection and does not indicate whether it is viral or bacterial.
  • See our Upper Respiratory Tract Tips for management.
• Bacterial Sinus Infection.
  • The sinus can become infected with bacteria in about 5% of colds. It starts as a viral sinus infection.
  • Main symptoms are increased sinus pain (mainly behind the cheekbone or eye) or return of fever.
  • The skin around the eyelids or cheeks may become red or swollen.
  • Teeth may hurt.
  • Nasal discharge and post-nasal drip lasts over 14 days without improvement. If discharge comes and goes, it is less likely a bacterial infection and more likely recurrent viral infections or allergies.
  • Color of discharge is yellow or green and tends to be very thick.
• Allergic Sinus Reaction.
  • Sinus congestion often occurs with nasal allergies (such as from pollen).
  • Sneezing, itchy nose and clear nasal discharge suggest allergies.

TREATMENT OF SINUS INFECTIONS AND ALLERGIES

• Viral Sinus Infection
  • ​Nasal washes with saline. See Nasopure's library for instructions on how to do this as well as videos to get comfortable with the procedure.
  • Nasal corticosteroids (such as Nasocort or Nasonex or their generic versions.)
  • Antibiotics are not helpful for the sinus congestion that occurs with colds.
• Bacterial Sinus Infection
  • Nasal washes with saline. See Nasopure's library for instructions on how to do this as well as videos to get comfortable with the procedure.
  • ​​Antibiotics by mouth.
• Allergic Sinus Reaction
  • Nasal washes with saline. See Nasopure's library for instructions on how to do this as well as videos to get comfortable with the procedure.
  • Nasal corticosteroids (such as Nasocort or Nasonex or their generic versions.)
  • ​Treatment of the nasal allergy with oral allergy medicines may help the sinus symptoms but the nasal corticosteriods are most effective.

Helpful treatments for all sinus congestion:

1. Nasal Saline:
   • Use saline (salt water) nose spray or rinse. This helps to loosen up the dried mucus. If you don't have saline, you can use a few drops of water. Use bottled water, distilled water or boiled tap water. Teens can just splash a little water in the nose and then blow. (See Dr Stuppy's blog for how to use nose sprays correctly.)
2. Fluids:
   • Try to get your child to drink lots of fluids.
   • Extra fluids can help to thin out the mucus discharge from the nose.
   • Extra hydration also loosens up any phlegm in the lungs to make it easier to cough it up.
3. Humidifier:
   • If the air in your home is dry, use a humidifier. Dry air makes nasal mucus thicker. (Do not use a humidifier when it is hot/humid or your air conditioner is on. It is not helpful at that point and too much humidity encourages mold.)
4. Decongestant Nose Spray (Age 12 years or Older):
   • Use this only if the sinus still seems blocked up after nasal washes.
   • Rinse the nose with saline first, then blow the nose.
   • Use the long-acting type (such as Afrin).
   • Dose: 1 spray on each side 2 times per day for only 2-3 days. Too much can lead to rebound congestion.
5. Pain Medicine:
   • To help with the pain, give an acetaminophen product (such as Tylenol) or ibuprofen (such as Advil).
   • Use as needed per package directions.
6. Cold Pack for Pain:
   • For pain or swelling, use a cold pack. You can also use ice wrapped in a wet cloth.
   • Put it over the sinus for 20 minutes.
   • Caution: Avoid frostbite and do not place this directly on the skin. Put it on a cloth on top of the skin.
7. Allergy Medicine:
   • If the child also has nasal allergies, give an allergy medicine.
   • Nasal corticosteroids (Nasocort, Nasonex, Flonase) are the preferred allergy medicines because they work better than oral antihistamines, but they can be used with antihistamines.
   • Long-acting antihistaines (such as Zyrtec) are preferred over short acting (like Benadryl). Reason: these meds do not cause your child to act sleepy. Age limit: 2 and older.
8. Follow up with us if:
   • Sinus pain lasts more than 24 hours after starting treatment
   • Sinus congestion lasts more than 2 weeks
   • Fever lasts more than 3 days
   • Symptoms worsen