What Are The Different Types of Sinus Infection?

Infection in the sinus cavities that surround the nose can be viral, acute bacterial, chronic bacterial, or fungal.

• VIRAL SINUS INFECTION – Viral is the most common and is what we feel when we have a cold. In this sinus infection, there is an abrupt onset, more common in the winter, with congestion and sinus pressure, and copious mainly clear nasal discharge. The discharge may have some color intermittently. This viral sinus infection begins to get better by day 5 and is usually mainly resolved by 7 days. Viral infections are treated with love, decongestants, saline rinse, rest, and hydration. They do not require antibiotics.
• ACUTE BACTERIAL SINUS INFECTION – Bacterial infection of the sinus cavities is quite common as well. It may occur following a viral infection or an allergy exacerbation as these lower the local immunity and create swelling that may block the sinus outflow tracts. This bacterial infection has similar symptoms to a viral infection but there is generally more consistent discoloration of the nasal secretions, a greater degree of facial pressure and pain, maybe accompanied with feeling generally not well, may have associated fever, and frequently is not resolving by day 5 and may not resolve at all without the assistance of antibiotic therapy. Typically treatment is a 10-day course of antibiotics, oral decongestants, possible oral prednisone treatment, saline rinses. In most cases, this will resolve this issue. If symptoms do not resolve following this treatment, follow up is needed with possible imaging and possibly more aggressive medical treatment.
• CHRONIC BACTERIAL SINUS INFECTION – Even if treated, an acute bacterial sinus infection may not fully resolve at all and may change into what is referred to as a chronic sinus infection. The facial pressure and pain, generally feeling poorly, fever, and discolored secretions may all resolve and the patient may be unaware they still have an infection. Typically the patient with a chronic sinus infection usually will have other complaints such as nighttime nasal congestion, snoring, sleep apnea, chronic cough, ear-popping, dizziness, hoarseness, throat clearing, among other complaints. Chronic sinus infection typically occurs when there are other predisposing structural issues such as a deviated septum, nasal polyps, or narrow sinus outflow tracts. Chronic sinus infection can now be successfully resolved with non-surgical balloon sinuplasty as an office procedure in our office under IV sedation. Associated structural issues are treated at the same time to reduce the risk of recurrence. These procedures only take about 15 minutes and patients can usually work the next day.
• FUNGAL SINUS INFECTION – Fungal sinus infection is a completely different issue altogether. This “infection” is actually not an infection at all. Instead, it is a severe local allergic reaction to mold spores. When a patient is highly allergic to mold spores they can create very significant swelling of the lining of the nose and sinuses with polyp formation. These polyps are not cancerous but instead are large grape-like masses of extremely swollen lining that obstruct the nose and the sinus outflow tracts. Frequently there is a build-up of a large thick fungal ball filling the sinus cavities and extensive polyps in the nose. There is frequently associated secondary bacterial infection present as well. Patients only get a small relief with oral antibiotics and typically feel temporarily much better after systemic steroid treatment. These patients are generally pretty miserable with severe congestion, poor sleep, snoring, possible sleep apnea, mouth breathing, facial pressure, and pain. They usually do not have a fever. The treatment of this condition requires a multifaceted approach. Balloon sinuplasty and polyp removal along with irrigation of the sinuses with an antifungal wash step one. Allergy drop therapy under the tongue based on skin testing in our office including all of the most common molds will help significantly blunt their over-exuberant allergic reaction to mold. In addition “biologic “ therapy using Dupixent can work to block the pathway that creates the nasal polyps from forming.

WHY DOES THE TYPE OF SINUS INFECTION MATTER?

Understanding what type of sinus infection you may have, any associated structural issues, and comprehensive allergy management are key aspects to successfully diagnosing and treating sinus infection. That is why we combine history and physical exam, along with high definition nasal endoscopy, miniCT sinus scan, as well as needle-free allergy skin testing on our patients. When appropriate we can offer a simple office procedure to clear infection when medical treatment has not succeeded. We also manage the allergy with the convenience and simplicity of allergy drop therapy that we formulate for our patients based on their skin testing and their history.

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For a more detailed and personalized evaluation and treatment plan, come see us for a consultation!  If you have been suffering from sinus issues come to see us for a consultation to get the best longterm game plan. Contact us today at 512.601.0303 to schedule an appointment!