Sinusitis is an often-misused term. It is frequently, but incorrectly, used to refer to a similar, but distinct condition called rhinitis. Rhinitis is inflammation of the nasal passages (not the sinuses), usually by a virus (the “common cold”) or an allergen (“hay fever”). Sinusitis, on the other hand, is inflammation of the sinus cavities, which are behind the cheeks and forehead, not in the nose at all. But, each of the sinuses drains through tiny “passages” into the nose. Therefore, both conditions cause nasal discharge, leading to the confusion between them. To add to the confusion, sinusitis often follows rhinitis. Similar to rhinitis, sinusitis may also be cause by a virus or allergen but additionally, can be caused by bacteria or fungi.
Since antibiotics are almost never helpful with the much more common rhinitis, but are often indicated for sinusitis, it is important to distinguish the two conditions. So, how does one know the difference? Below are five signs of a sinus infection or sinusitis:
-
Headaches
Pain is among the most significant signs of sinusitis and is not common with rhinitis. There are sinuses located behind the forehead (frontal sinuses), behind the cheeks (maxillary sinuses), behind the nose (ethmoid sinuses), and near the eyes (sphenoid sinuses). When any of these develops an infection, the resulting swelling and inflammation usually produces pain similar to a headache.
Pain may be felt generally throughout the head but will more often be experienced in the specific part of the head with the infected sinus. Therefore, one sided, or very localized pain is more suggestive of a sinus infection that global head pain. Sinus headaches are often worse upon awakening in the morning due to the fluids that accumulated throughout the night. Changes in air pressure can also worsen sinus headaches.
-
Thick and Colored Nasal Secretions
The nasal drainage of rhinitis is usually thinner, clear or slightly yellow in color and expressed from both nostrils equally. In contrast, the nasal drainage associated with a sinus infection is thicker, darker green or brown, and sometimes bloody. Importantly, since sinus infections are most often one-sided, dark or bloody secretions from only one nostril strongly suggest a sinus infection rather than a cold.
-
Fever
More often than the common cold, sinusitis can cause an increase in your body temperature over 100.4 degrees Fahrenheit, the point at which temperature elevation is considered to represent a fever. You can relieve the fever and some of the discomfort by using over-the-counter medication such as Ibuprofen (Advil) and acetaminophen (Tylenol). As with all over-the-counter medications, you should consult your doctor prior to taking them. Children under three months of age who exhibit signs of sinusitis or fever should see a doctor right away.
-
Localized, specific symptoms
Unlike the common cold, that tends to produce symptoms in multiple locations including the nose, the throat, the bronchi and the lungs, sinus infections are much more specific to the sinus that is infected. Therefore, phlegm production from the lungs, loss of voice, intestinal symptoms, chest pain or trouble breathing all suggest conditions other than a sinus infection. Chest pain, trouble breathing, or bloody phlegm produced from a cough should prompt evaluation by a doctor right away
-
Long-Lasting Symptoms
In the same way that many colds are inappropriately referred to as a sinus infection, sinus infections can be inappropriately confused with an unusually persistent cold. It is unusual for the common cold to last beyond 10-14 days. Instead, since sinusitis often follows the common cold, cold-like symptoms that persist beyond 2 weeks often represent sinusitis. In fact, acute sinusitis can last for four weeks while chronic sinusitis can last for months. Therefore, any symptoms consistent with a cold or sinusitis that persist beyond two weeks should be evaluated for possible sinusitis.