Visit your doctor when you feel pain or pressure in your upper face together with nasal congestion or discharge, postnasal drip or ongoing bad breath unrelated to dental problems.
Simple congestion and a low-grade fever is probably a cold, and special medication or antibiotics are not required. But together with facial pain or headaches, it may well be a sinus infection.
Rare but possible sinus infection complications
The following symptoms require immediate hospital treatment:
- Headache, fever and soft tissue swelling over the frontal sinus, especially for children, may be due to an infection of the frontal bone.
- Infection in the eye socket due to ethmoid sinusitis causes swelling followed by drooping of the eyelid. This leads to impaired eye movement, with pressure on the optic nerve possibly resulting in blindness.
- Due to ethmoid or frontal sinusitis, blood clots can form in the sinus area. In addition to the symptoms of orbital infection above, the pupil may be fixed and dilated. Symptoms usually begin on one side of the head and spread to the other.
- The most dangerous complication of sinusitis is the spreading of infection from frontal and sphenoid sinuses to the brain, either through the bones or blood vessels. Mild personality changes, headache, altered consciousness, visual problems or seizures occur. If not treated, coma and even death may result.
Examination and how a sinus infection is diagnosed
Sinusitus must be distinguished from a simple upper respiratory infection, common cold or migraine.
After going through your history, your doctor would examine your throat, nose and sinuses. He would peer in your nose for signs of polyps, shine a light against the sinus for signs of inflammation and tap over a sinus area looking for infection.
If he finds red swollen nasal passages, pus-like drainage from the nasal passages, tenderness when he taps your cheeks or forehead, and swelling around the eyes and cheeks, he would most likely diagnose you with a sinus infection.
If it fails to respond to treatment, you may be referred to an ear, nose and throat (ENT) specialist who specializes in sinusitis. Because regular x-rays of the sinuses are unreliable for diagnosing sinusitis, more in-depth, expensive tests may be required.
- sinus CT scan
- MRI
- Ultrasound
- Rhinoscopy
- Sometimes the affected sinus is drained and tested for organisms.
If your sinus disease is chronic or does not improve after several rounds of antibiotics, laboratory tests may be carried out:
- Blood tests to rule out other conditions, such as immune deficiency disorder.
- A sweat or blood test to rule out cystic fibrosis.
- Biopsy of the linings of the nose or sinuses to ensure they are healthy. In more serious types of fungal sinus disease, a bone biopsy determines if the fungus has penetrated nearby bone and again, is done by inserting flexible instruments through the nose.