Sinusitis describes inflammation of lining of the sinuses, air-filled spaces in the facial bones around the nose and eyes. Thirty million cases of sinusitis are diagnosed annually in the U.S., according to the Centers for Disease Control and Prevention 2. A viral infection is the culprit in 90 to 98 percent of acute sinusitis cases -- those lasting less than 4 weeks. Bacterial infection develops in no more than 2 percent of cases. Chronic sinusitis, lasting 12 weeks or longer, is rarely due to an infection. Your symptoms and their timing help point to the correct diagnosis, whether its sinusitis or another condition affecting your sinuses.
If you are experiencing serious medical symptoms, seek emergency treatment immediately.
Opaque -- as opposed to clear -- nasal discharge is a hallmark symptom of sinusitis. The discharge is typically yellowish or green and may be tinged with blood. The blood is due to minor bleeding from the irritated lining of the sinuses and nose, and usually appears as red to dark brown streaks in the nasal mucus. Frank bleeding, such as occurs with a bloody nose, is not typical of sinusitis. Nasal stuffiness and facial pain, pressure or fullness are other hallmark symptoms of sinusitis, according to April 2015 guidelines published by the American Academy of Otolaryngology -- Head and Neck Surgery 1.
- Opaque -- as opposed to clear -- nasal discharge is a hallmark symptom of sinusitis.
- Frank bleeding, such as occurs with a bloody nose, is not typical of sinusitis.
Other Possible Symptoms
Smelly Mucus in the Nose
Sinusitis can cause additional symptoms in some people. These may include: -- decrease sense of smell and possibly taste -- bad breath -- cough that increases at night -- sore throat -- facial tenderness over the sinuses -- mild fatigue -- pain in the upper teeth -- low fever, usually less than 101 F
Importantly, the presence of these additional symptoms does not help distinguish simple, acute viral sinusitis -- for which antibiotics are not useful -- from the more uncommon bacterial sinusitis.
When To See Your Doctor
Acute viral sinusitis, which typically develops after a cold, will usually go away on its own in about 7 to 10 days. Over-the-counter pain relievers such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) might help relieve your discomfort. Nasal saline irrigation might also provide symptom relief.
Sinusitis symptoms that persist could indicate the condition is becoming chronic or a complication has developed, and medical evaluation is needed. Nasal polyps -- noncancerous growths in the nose or sinuses -- are a possibility and can cause periodic bloody nasal discharge. These growths are common among people with chronic sinusitis. Less commonly, cancerous growths of the nose or sinuses can cause sinusitis-like symptoms. In young children, sinusitis symptoms with bloody nasal discharge might be due to a foreign body lodged in the nose, such as a bead or a bean. A high fever in a child or an adult with sinusitis symptoms warrants a visit to the doctor.
Reviewed by: Tina M. St. John, M.D.
- Acute viral sinusitis, which typically develops after a cold, will usually go away on its own in about 7 to 10 days.
- Less commonly, cancerous growths of the nose or sinuses can cause sinusitis-like symptoms.
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Complications of Nasal Polyp Surgery
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Bump on the Inside of the Nose
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A Runny Nose in a Toddler
- Otolaryngology -- Head and Neck Surgery: Clinical Practice Guideline (Update): Adult Sinusitis
- Centers for Disease Control and Prevention: Get Smart: Know When Antibiotics Work: Adult Treatment Recommendations
- Merck Manual Professional Version: Sinusitis
- American Family Physician: Acute Rhinosinusitis in Adults
- Treating Chronic Sinusitis. Informed Health Online: Institute for Quality and Efficiency in Health Care. https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072668/.
- Treating Chronic Sinusitis. Informed Health Online: Institute for Quality and Efficiency in Health Care.
- Chow AW, Benninger MS, Brook I, et al. IDSA Clinical Practice Guideline for Acute Bacterial Rhinosinusitis in Children and Adults. Clin Infect Dis. 2012;54(8):e72–e112.
- Shaikh N, Wald ER. Decongestants, Antihistamines and Nasal Irrigation for Acute Sinusitis in Children. Cochrane Database of Systematic Reviews. 2014. doi:10.1002/14651858.cd007909.pub4.
- Wald ER, Applegate KE, Bordley C, et al. Clinical Practice Guideline for the Diagnosis and Management of Acute Bacterial Sinusitis in Children Aged 1 to 18 Years. Pediatrics. 2013;132(1):e262-80.
Diane Marks started her writing career in 2010 and has been in health care administration for more than 30 years. She holds a registered nurse license from Citizens General Hospital School of Nursing, a Bachelor of Arts in health care education from California University of Pennsylvania and a Master of Science in health administration from the University of Pittsburgh.