Acute Sinusitis

Acute sinusitis may also be referred to as acute rhinosinusitis or more commonly as a classic “sinus infection.”  By definition, the symptoms of acute sinusitis will last less than 4 weeks in duration, rather than the 12 weeks or more necessary to characterize a sinus infection as chronic sinusitis or a chronic sinus infection.  Of note, some physicians classify a sinus infection that lasts from 4 to 12 weeks as subacute sinusitis.  The term recurrent sinusitis refers to repeated acute sinus infections but can easily be confused with a chronic sinus infection.  This distinction is particularly important to differentiate as an allergist because the workup and treatment of recurrent sinus infections is quite different than the workup and treatment of a chronic sinus infection.

Acute sinusitis is most commonly caused by the “common cold” or another type of virus.  Most of the time, the acute sinusitis is self-limited and resolves without treatment in 7-10 days.  Approximately 1-2% of sinusitis caused by viruses will result in a subsequent bacterial sinus infection.  Rarely, a fungus may be the cause of a sinus infection.  Other factors that predispose an individual to develop acute sinusitis include allergic rhinitis (i.e., hay fever), a deviated nasal septum, nasal polyps, a fixed nasal obstruction (e.g., tumor, foreign body), cystic fibrosis,  immunological deficiencies (e.g., HIV/AIDS, diabetes mellitus, common variable immunodeficiency), immunosuppressant medications (i.e., medications that suppress the immune system such as azathioprine, cyclosporine, corticosteroids, and many “biological” medications such as adalimumab, secukinumab, abatacept, infliximab, etanercept), dental and/or periodontal infections, and chemical irritation (e.g., cigarette smoke, chemical fumes).

The symptoms of acute sinusitis typically involves one or more of the following:

  • Nasal congestion
  • Discolored nasal discharge (e.g., yellow, green, brown discharge)
  • Post-nasal drip
  • Sore throat
  • Sinus pressure
  • Sinus headaches
  • Bad breath
  • Fatigue
  • Fever
  • Radiation of pain to the teeth and/or ears
  • Clogged ears
  • Cough

Complications from acute sinusitis is uncommon nowadays in the era of better diagnostic techniques and antibiotics, however, a few complications can still occur and are as follows:

  • Meningitis
  • Osteomyelitis (i.e., bone infection)
  • Cellulitis (i.e., skin infection)
  • Chronic sinusitis
  • Visual disturbances (if the infection spreads to one’s eye)
  • Decreased or loss of sense of smell

The diagnosis of acute sinusitis is usually a clinical one.  The history that the patient describes along with certain findings on physical examination in most cases is usually enough to diagnose the individual.  Other methods that are utilized by physicians may include allergy testing, rhinolaryngoscopy (i.e., small endoscopic instrument used to obtain direct visual inspection of the nose, throat, and vocal cords), radiological studies (e.g., CT scan, MRI), and/or nasal cultures.

The treatment of acute sinusitis most of the time requires no treatment at all.  This is so because most cases of acute sinusitis are caused by a virus which usually resolves on its own.  In patients who have a bacterial sinus infection or who develop a secondary bacterial infection, antibiotics may be needed to eradicate the infection, particularly if the symptoms persist, worsen, or are severe.  In addition, supplemental use of saline nasal irrigation, nasal corticosteroids, decongestants, and/or over-the-counter analgesics are quite helpful in many cases of acute sinusitis to reduce symptoms.  It is also recommended to stay hydrated by drinking water.

The prevention of episodes of acute sinusitis can be facilitated by seeing a board certified allergist, like the ones at Black & Kletz Allergy.  The allergy specialist will perform a comprehensive history and physical and if necessary will do allergy skin testing to identify if and what allergens are allergenic to the patient.  Depending on the frequency of episodes of acute sinusitis and/or allergy symptoms, the allergy doctor will prescribe different medications (i.e., antihistamines, decongestants, nasal sprays, eye drops) used to alleviate the individual’s allergy symptoms.  He may also recommend allergy shots (i.e., allergy injections, allergy immunotherapy, allergy hyposensitization) which is effective in 80-85% of patients receiving allergy shots.  The allergists at Black & Kletz Allergy treat both adults and pediatric patients and have been doing so in the Washington, DC, Northern Virginia, and Maryland metropolitan area for more than one half a century.

Black & Kletz Allergy has 3 convenient locations with on-site parking located in Washington, DC, McLean, VA (Tysons Corner, VA), and Manassas, VA.  The Washington, DC and McLean, VA offices are Metro accessible and we offer a free shuttle that runs between the McLean, VA office and the Spring Hill metro station on the silver line.  The allergists at Black & Kletz Allergy are extremely knowledgeable regarding the diagnosis and treatment of acute sinusitis and other sinus diseases.  In addition, we treat patients with environmental allergies, medication allergies, insect sting allergies, food allergies, eczema, asthma, hives, swelling episodes, generalized itching, contact dermatitis, eosinophilic esophagitis, and immune disorders.  To schedule an appointment, please call any of our offices or you may click Request an Appointment and we will respond within 24 hours by the next business day.  We have been servicing the greater Washington, DC area for many years and we look forward to providing you with excellent state-of-the-art allergy care in a friendly and professional environment.