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Doc Talk Doc Talk: Sinus infections come with the season

  • Published Monday, Nov. 26, 2012, at 11:06 p.m.

By now, many of you parents out there have realized that a very special time of year is upon us.

I wish I was referring to the holidays, but unfortunately that’s not the case. I’m referring to the wintertime increase in respiratory infections such as the common cold, ear infections, strep throat and, of course, influenza.

One of the most common reasons people go to the doctor this time of year is for sinus infections, or rhinosinusitis. This term is a combination of sinusitis (inflammation of the lining of the sinuses) and rhinitis (inflammation of the lining of the nose).

Symptoms include nasal congestion, pain and pressure in the face, headaches and cough. The most common cause is viral infection, not bacterial infection as many people believe. Viral rhinosinusitis can progress to bacterial rhinosinusitis, but this happens in less than 2 percent of cases. Bacterial rhinosinusitis can also occur in people with uncontrolled allergies.

Many people who come to the doctor’s office with sinus infections are hoping to have antibiotics prescribed. Antibiotics are only effective against bacteria; they do not work on viruses. While there are ways to distinguish between viral and bacterial sinus infections, these methods are only available in research settings. Unfortunately, in a typical doctor’s office there is no reliable way to distinguish the two. (The color of mucous is meaningless in this regard.)

In some ways it does not really matter. Both viral and bacterial sinus infections eventually go away on their own in most otherwise-healthy people, usually in seven to 10 days. Some people with bacterial infections may be sick for a longer period, in which case an antibiotic may be helpful. Medical evidence is weak even on this point, because study results are conflicting. Any benefit they may have must be weighed against any substantial side effects.

So what can you do? Over-the-counter pain relief medications, such as Tylenol or ibuprofen, will help with the pain and pressure. Nasal saline rinses and decongestants, such as Sudafed, can help with the congestion. Antihistamines are not that helpful unless you also have allergies.

If your symptoms have not improved after seven to 10 days, consider seeing your doctor. If you have a temperature of 101 degrees or higher, or your symptoms have not improved, see your doctor sooner.

Keep in mind that all these recommendations are aimed at otherwise-healthy people. If you have other ongoing medical problems, check with your doctor.

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