Beyond the Bedside: Sinus Infection

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Beyond the Bedside: Sinus Infection

One of the most common problems physicians see in the office is what patients often call “sinus infections.”

A similar, but more encompassing term used in the medical field is “upper respiratory tract infection” or URI. They are terms used to diagnose a constellation of symptoms brought on by an infectious organism that causes inflammation of the mucosal membranes lining the nose, sinuses, mouth, and throat but do not involve the lungs. These symptoms include headache, fever, sneezing, body aches, runny nose, congestion, sore throat, and cough.
The real question to answer is what type of organism is causing the infection? A virus or bacteria? Unfortunately, there is a lot of misinformation leading patients to think that antibiotics are the “cure” for their symptoms. In fact, antibiotics are rarely helpful for URIs. This is because upwards of 95% of URIs are caused by viruses. Antibiotics are only helpful for bacterial infections; thus, they have no effect on viruses. Thankfully, viruses typically run their course after 7-10 days, but they can certainly leave lingering inflammation that drags on the symptoms. For instance, coughing is known to last 4-6 weeks after a viral URI.

The next time you have a “sinus infection,” consider this…

There is a 95% chance (or higher) that it is caused by a virus which your immune system should eliminate after 10 days. If your symptoms are no better after 10 days, you develop high-grade fevers (102 F or higher), or you have thick, discolored nasal drainage with facial pain for 3-4 days, then you need evaluation. You may have a more severe infection, possibly a bacterial infection. Fever with chest discomfort or shortness of breath is concerning for lung involvement and needs to be evaluated.

While antibiotics are rarely helpful for URIs, washing hands regularly and staying up to date on your vaccines is very effective at preventing infections. An annual vaccine for influenza is recommended for everyone older than 2 months. For everyone older than 65 and for some who are younger, there is now a single vaccine to protect against bacterial pneumonia called Prevnar-20. This was previously a 2-shot series. The Center for Disease Control (CDC) has great resources for any vaccine questions.

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