Sinusitis (Sinus Infection)
Most acute sinusitis is viral and self-limiting — antibiotics are rarely the first answer.
Sinusitis is inflammation of the sinus linings, usually triggered by a viral upper-respiratory infection. It's acute when symptoms last under four weeks and chronic when they persist 12 weeks or more. Treatment aims to drain the sinuses and reduce inflammation; bacteria are only involved in a minority of cases.
Causes & risk factors
- Viral upper respiratory infections (by far the most common)
- Allergic rhinitis keeping sinuses inflamed
- Deviated nasal septum or nasal polyps
- Dental infections spreading upward
- Bacterial or, rarely, fungal infection
Symptoms
- Facial pain or pressure, often around the cheeks or forehead
- Thick nasal discharge (yellow or green)
- Nasal congestion and reduced sense of smell
- Post-nasal drip, cough worse when lying down
- Fever in bacterial sinusitis
How it's diagnosed
- Clinical — no imaging needed in most acute cases
- CT sinuses when chronic, recurrent, or complicated
- Nasal endoscopy by an ENT specialist for persistent symptoms
- Allergy testing when atopy is suspected
Evidence-based treatment
- Saline nasal irrigation — evidence-based and underused
- Intranasal corticosteroid sprays
- Decongestants for short-term relief (maximum 3–5 days)
- Antibiotics only when bacterial infection is likely (severe, worsening after improvement, or lasting > 10 days)
- Surgical correction for structural causes in chronic disease
Prevention
- Treat allergic rhinitis proactively
- Avoid cigarette smoke and known irritants
- Hand hygiene to reduce viral infections
- Humidify dry indoor air in winter
Who treats this?
Sinusitis (Sinus Infection) — FAQ
Green mucus — do I need antibiotics?
No. Green or yellow mucus is normal in any viral upper-respiratory infection and does not by itself mean bacterial infection.
When should chronic sinusitis be referred to ENT?
If symptoms persist beyond 12 weeks despite standard treatment, if you have recurrent acute episodes, or if imaging shows structural problems.
Other conditions
This page is general information, not medical advice for any specific person. For diagnosis and treatment, book a consultation.