Acute sinusitis

Acute sinusitis: causes and treatment

Acute sinusitis is one of the main reasons for consultation in primary care. However, its nonspecific symptoms complicate its diagnosis, so that sometimes it is not treated correctly.

Acute sinusitis is an infectious inflammatory process, usually of viral etiology, that affects one or more paranasal sinuses. It usually has its origin in viral respiratory infections of the upper airways.

It becomes the third cause of prescription of antibiotics in primary care, although in most cases it is due to a viral infection. Therefore, it has become a favorable condition for the inadequate use of these medicines.

The symptomatology of the disease is due to an obstruction in the drainage of the paranasal cavities. The result is that mucus builds up in the breasts and they become inflamed.

Symptomatology of acute sinusitis

Acute sinusitis

The symptoms of acute sinusitis are varied. Among them can be mentioned the following:

  • Nasal secretions and nasal congestion
  • Pain and swelling around the eyes, cheeks or nose
  • The pressure in the ears
  • A headache and jaw
  • A cough that usually gets worse at night
  • Bad breath
  • Fatigue
  • Fever


Acute sinusitis is mostly due to the common cold. It is an infrequent complication of this type of viral infections, which damage the sinus mucosa, facilitating the colonization and penetration of bacteria.

This bacterial superinfection caused by a common cold actually occurs in a minority of cases. However, in a high percentage of patients with suspected sinusitis, antibiotics are used for their treatment, even when they are not effective.

By agreement, acute sinusitis is the infectious process that lasts up to 4 weeks. Chronic sinusitis is one that lasts at least 3 months, which recurs 3 or 4 times a year or in which the treatment is not effective.

However, the causes of sinusitis may be other causes that do not involve a previous viral infection. Some risk factors for the development of sinusitis are:

  • Allergic rhinitis and other allergic conditions that affect the sinuses.
  • Abnormalities in nasal structures, such as deviations in the septum, polyps or nasal tumors.
  • Other conditions, such as cystic fibrosis or immune disorders such as HIV.


Acute sinusitis

The diagnosis of acute sinusitis is complex because its symptoms are nonspecific and may mask another type of condition. The imaging study, using computed tomography or magnetic resonance, is very useful in the diagnosis since it can show details of the paranasal sinuses. You also learn about causes of panic attacks.

Another invasive diagnostic method that can be used is nasal endoscopy. In it a flexible and thin tube is inserted through the nose, allowing the observation of the paranasal sinuses.

Currently, you have to sinus puncture with aspiration and culture as the gold standard for the diagnosis of the disease. However, it is an invasive technique that presents a series of disadvantages. Therefore, it is not used in all cases.

Treatment of acute sinusitis

In a large number of cases, acute sinusitis does not require any specific treatment, since the disease resolves on its own. However, there are certain measures that can alleviate the annoying symptoms of the disease:

Salt solutions

They are applied in aerosol for the nostrils. This allows clearing the nasal passages, relieving the congestion characteristic of the sinusitis.

Nasal corticosteroids

Acute sinusitis

Also in the form of an aerosol, these compounds help to reduce the inflammation of the paranasal sinuses. However, its use is currently under controversy. Some experts believe that they can hinder the natural drainage of salt respiratory secretions.


They can be administered in the form of aerosol, pills or liquids. Its temporary use can help alleviate the symptoms of nasal congestion. But its use for prolonged periods can have side effects. For example, greater later congestion due to a “rebound” effect.


These drugs, which include paracetamol, ibuprofen or aspirin can help treat the pain associated with sinusitis.


Acute sinusitis

Normally, the use of antibiotics is not indicated. Not even in some cases in which a bacterial infection is confirmed, since it usually disappears on its own.

However, in certain cases in which sinusitis is persistent or does not respond correctly to other treatments, the use of these antimicrobials may be included.

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