What Complications Might Children With Acute Sinusitis Experience
The most common complication is chronic sinusitis. Chronic sinusitis causes similar symptoms to acute sinusitis but lasts longer.
Other complications are rare but can be serious. This can include infections spreading from the sinuses to around an eye or into bones, blood or brain. Children are more prone than adults are to such complications. See your doctor urgently if you child with sinusitis has swelling or redness of an eyelid or cheek.
How Is Chronic Sinusitis Treated
Chronic sinusitis is more difficult to treat. Primary treatment includes:
- Nasal saline washes
- Nasal steroid sprays
Children with chronic sinusitis that does not respond to antibiotics may need antral irrigation with targeted antibiotic therapy and adenoidectomy. An adenoidectomy is surgery to remove the adenoid. The adenoid is lymphoid tissue located behind the nose. It helps build up the body’s immunity by trapping viruses that enter through the mouth. Enlarged adenoids can cause chronic sinusitis or sleep issues, and no longer provide health benefits.
In older children and children with cystic fibrosis, endoscopic sinus surgery may be recommended. Some children may develop eye or intracranial medical problems from sinusitis that can be quite serious. Hospital admission for intravenous antibiotics and emergent surgical procedures may be required.
How Do I Know When My Child Has Sinusitis
The following symptoms may indicate a sinus infection in your child:
- a “cold” lasting more than 10 to 14 days, sometimes with a low-grade fever
- thick yellow-green nasal drainage
- post-nasal drip, sometimes leading to or exhibited as sore throat, cough, bad breath, nausea and/or vomiting
- headache, usually in children age six or older
- irritability or fatigue
- swelling around the eyes
Young children have immature immune systems and are more prone to infections of the nose, sinus, and ears, especially in the first several years of life. These are most frequently caused by viral infections , and they may be aggravated by allergies. However, when your child remains ill beyond the usual week to ten days, a serious sinus infection is likely.
You can reduce the risk of sinus infections for your child by reducing exposure to known environmental allergies and pollutants such as tobacco smoke, reducing his/her time at day care, and treating stomach acid reflux disease.
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How Will The Doctor Treat Sinusitis
After the doctor confirms the sinusitis infection in your baby, they may suggest the following treatments .
If your babys nose still seems to be stuffed and is causing discomfort, other alternatives like nasal aspirator or nasal bulb syringe to clean the babys nose could also be tried under pediatric consultation.
Note: Do not give antihistamines and over-the-counter decongestants to babies less than two years old .
In some other severe cases, surgical treatment may involve the removal of adenoid tissue from behind the nose. The adenoid tissue may not directly block the sinuses, but its infection, called adenoiditis, causes symptoms similar to sinusitis .
Consider Nose Strips To Ease Breathing In Older Kids
Although Rolnick says even older children typically pull off those drugstore nose strips as soon as you place them on, when they do stay on they open the passageways enough to help your child breathe easier.
If you have an older child you think might allow the strips to remain, especially when they are sleeping, this could be worth a try.
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Treatment For Sinusitis From A Gp
If you have sinusitis, a GP may be able to recommend other medicines to help with your symptoms, such as:
- steroid nasal sprays or drops â to reduce the swelling in your sinuses
- antihistamines â if an allergy is causing your symptoms
- antibiotics â if a bacterial infection is causing your symptoms and you’re very unwell or at risk of complications
You might need to take steroid nasal sprays or drops for a few months. They sometimes cause irritation, sore throats or nosebleeds.
A GP may refer you to an ear, nose and throat specialist if, for example, you:
- still have sinusitis after 3 months of treatment
- keep getting sinusitis
- only have symptoms on 1 side of your face
They may also recommend surgery in some cases.
What Are The Treatment Options
If you take your child to an ENT specialist, or otolaryngologist, they will examine your childs ears, nose, and throat. A thorough history and examination usually leads to the correct diagnosis. The doctor may also look for factors that make your child more likely to get a sinus infection, including structural changes, allergies, and problems with the immune system.
Occasionally, special instruments will be used to look into the nose during the office visit. Imaging of the sinuses, such as a CT scan, are not recommended in acute sinusitis unless there are complications from the infection. Radiation safety concerns may limit imaging scans, especially in children younger than six-years-old.2
Acute sinusitisWhen bacterial sinusitis is present, most children respond very well to antibiotic therapy. Nasal steroid sprays or nasal saline drops or gentle sprays may also be prescribed for short-term relief of stuffiness. Over-the-counter decongestants and antihistamines are generally not effective for viral upper respiratory infections in children, and should not be given to children younger than two-years-old.
Chronic sinusitisIf your child suffers from two or more symptoms of sinusitis for at least 12 weeks and has signs of sinus pressure, he or she may have chronic sinusitis.3 Chronic sinusitis or more than four to six episodes of acute sinusitis per year indicates that you should see an ENT specialist, who can recommend appropriate medical or surgical treatment.
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How Can I Care For My Child With Acute Sinusitis
To help relieve the pain and discomfort caused by sinusitis, try the following home treatments for your child:
- Make sure they rest to help their body to heal faster.
- Keep them hydrated by encouraging them to drink lots of fluids this helps to thin the mucus.
- Hold a hot compress or warm face pack over the painful area.
- Consider using saline nasal spray or drops, or a sinus rinse of home-made saline solution to relieve congestion and blockage in their nose.
|Home-made saline solution|
|Home-made saline solution is made using 1/4 teaspoon non-iodised salt, 1/4 teaspoon baking soda dissolved in 250 mL of warm water. You can buy a sinus rinse bottle or pot from your pharmacy. Read more about saline nasal sprays, drops and rinses.|
Steam inhalation is a traditional remedy but is not recommended. This is because there is little evidence that it helps. Also, there is a risk your child might burn themselves. However, some people say that their nose feels clearer for a short while after a hot shower.
Pain Or Pressure In Your Sinuses
Facial pain is a common symptom of sinusitis. You have several different sinuses above and below your eyes, as well as behind your nose. Any of these air-filled cavities can hurt when you have a sinus infection.
Inflammation and swelling can cause your sinuses to ache with dull pressure. This is because inflammation may alter the typical path of mucus from the nose to the back of the throat.
You may feel pain in:
- your forehead
- on either side of your nose
- in your upper jaws and teeth
- between your eyes
This may lead to a headache. Headaches caused by sinus infections can occur where the sinuses are or in other places.
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How You Can Treat Sinusitis Yourself
You can often treat mild sinusitis without seeing a GP by:
- getting plenty of rest
- taking painkillers, such as paracetamol or ibuprofen
- avoiding allergic triggers and not smoking
- cleaning your nose with a salt water solution to ease congestion
You do not need to use all of the solution, but make a fresh solution each time you clean your nose.
Types Of Sinus Infections: Chronic Vs Acute
There are four types of sinus infections. These classifications depend on the length and frequency of the infection:
- Acute sinusitis.This type of sinus infection lasts only for a short time, defined by the American Academy of Otolaryngology as less than 4 weeks. This short-term infection is usually part of a cold or other respiratory illness. It may also be caused by a bacterial infection .
- Subacute sinusitis. A subacute sinus infection lasts between 4 and 12 weeks .
- Recurrent acute sinusitis. An acute sinus infection is considered recurrent if the infection returns four or more times within a year, with each infection lasting 7 days or more.
- Chronic sinusitis.Chronic sinus infections last for more than 12 weeks or continue to recur.
Many sinus infection symptoms are common in both acute and chronic forms. Seeing a doctor is the best way to learn if you have an infection, find the cause, and get treatment.
For cases of acute bacterial sinus infections, these symptoms last at least 10 days without improving, or they worsen within 10 days after seeming to improve. In this case, its important to talk with a doctor, such as a general practitioner or an ear, nose, and throat doctor , to get a diagnosis and treatment plan.
Learn more about the symptoms of a sinus infection below.
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What Is Sinus Infection
Sinuses are small air spaces in the bones around the nose. Four sets of hollow spaces are located in the cheekbones, forehead, on the sides of the nose bridge, and behind nasal passages in front of the brain.
Sinuses in the cheekbones are called maxillary sinus, forehead frontal sinus, behind nasal passages ethmoid sinuses, and deep in the brain sphenoid sinus.
The infection attacks these air spaces in the bones, and sometimes they are swollen. In simple terms, sinusitis is an inflammation of the lining of the nose and sinuses. The mucous membranes that line the mouth and the nose also line the sinuses .
Sinusitis is an inflammation of the sinus due to viral or bacterial infections . Depending on the duration for which the symptoms stay, it can be categorized into the following types :
- Acute: Acute sinusitis is a condition where the symptoms last less than four weeks and improve with treatment.
- Sub-acute: The symptoms last four to eight weeks and do not subside with initial treatment.
- Chronic: This is a condition of repeated acute sinusitis or previous infections, which were inadequately treated. The symptoms last more than eight weeks.
- Recurrent: As the name suggests, recurrent is a condition where acute sinusitis repeats three or more times a year. You should consult an otolaryngologist in this case.
Which Antibiotics Are Best For Sinus Infections In Children
- The antibiotic of choice for both children and adults who are not allergic to penicillin is amoxicillin with clavulanic acid .
- Azithromycin is NOT recommended for sinusitis due to bacterial resistance.
- Cefinir and other cephalosporins are NOT recommended for sinusitis except in combination therapy with clindamycin for children with non-life- threatening allergic reactions to penicillin. In these cases, the cephalosporin of choice is cefixime .
- Levofloxacin or doxycycline are the recommended antibiotics for adults with true penicillin allergies. Levofloxacin can also be considered for the treatment of children with life-threatening allergic reactions to penicillin. Doxycyline is not for use in children.
- Oral decongestants are not recommended for the treatment of sinusitis. Antihistamines may be used if there are underlying seasonal/environmental allergies.
- Nasal steroid sprays and nasal saline flushes can be helpful for sinusitis.
Lou Romig, MD, FAAP, FACEP, Medical Director
After Hours Pediatrics Urgent Care
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Treatment Of Sinusitis Caused By Allergies
If an allergy is the cause of your child’s sinusitis, an allergist will lay out a plan to avoid triggers. Additionally, your child’s allergist may treat you or your child with medications or allergy shots that can help prevent future periods of sinusitis.
Environmental control measures such as avoiding allergens are crucial for people with rhinitis triggered by indoor allergens such as dust mites, molds or animal dander. This can prevent the need for surgery or prevent the return of sinusitis after surgery.
When other treatments or medications are unsuccessful, endoscopic sinus surgery may be considered. When contemplating sinus surgery, be sure to weigh the many factors. This can be a very difficult decision and you should seek the opinion of your allergist. Sinus surgery does not guarantee that sinusitis will not reoccur. Most patients still need medical treatment to prevent the return of chronic sinusitis.
What Are The Symptoms Of Sinus Infection In Kids
Its that time of year again! Before you know it, the weather will be changing and sinus infection in kids will be commonplace. The rapid change in weather coupled with the underdeveloped sinuses of children makes them especially susceptible to pediatric sinusitis. Very often, it is hard to diagnose it in children because it sometimes appears to be caused by other issues like allergies or other viral illnesses.
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Does Your Child Need Antibiotics For A Sinus Infection
- Infectious disease specialists agree on the following criteria for treating sinus infections with antibiotics:
- Symptoms lasting for 10 days or more and not improving
- Symptoms with fever over 102 degrees lasting for 3-4 days in a row
- Cold symptoms lasting 5-6 days that improved but were then followed by new fever, headache, cough, nasal discharge or facial pain
- Xrays are NOT accurate for diagnosing sinusitis. They can result in both under-diagnosis and over-diagnosis. The best test to detect the presence of infection is a CT scan of the sinuses.
How Sinus Infection Is Treated
The treatment for a sinus infection depends on the type of sinusitis and the source of the inflammation or infection. You might feel better with treatment for your symptoms as your sinus infection resolves.
Acute viral sinusitis can usually resolve on its own, acute bacterial sinusitis can usually be cured with antibiotics, and anti-fungal medications might be needed for treating fungal sinusitis, Getting treatment for allergies that might be contributing to an acute or chronic sinus infection can help, and endoscopic surgery may be needed in some cases of chronic sinusitis.
Treatment of chronic sinusitis may complicated, as abnormal tissue blocking the sinus cavities could require surgery.
Verywell / Tim Liedtke
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Take Your Child Into A Warm Shower To Help Ease Congestion
Because steam moistens the sinus passageways, which both helps your child feel better and may cause mucous clumps to pass, warming up your childs sinus passages is a wonderful treatment, Dr. Rolnick says.
Rolnick doesnt recommend leaning over a pot of steaming water as adults sometimes do, because the child might touch or knock over the water and get burned. Instead, she suggests placing the child in a warm shower, accompanying them if the child is young.
An alternative is to have your child lie on the bed while you place a warm washcloth over their nose and cheeks. The best way to heat up the washcloth is to run it under warm water, then squeeze the liquid out. Have a second washcloth handy so you can replace it as it cools.
What Are The Symptoms Of Sinusitis
Main symptoms are headache and pressure or pain in the forehead or face. The nose may be stuffed and runny, with a green or yellow-green discharge. Swollen eyes, with pain behind them and dark circles underneath, may occur. The throat may become sore. Children may be irritable, and have a long-lastingcough, in addition to sinus congestion. Symptoms usually go away in 7 to 21 days.
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Why Choose Children’s Colorado For Your Child’s Sinusitis
The at Children’s Colorado has been operating for over 20 years. It is staffed by a pediatric otolaryngologist, an infectious diseases specialist and an allergist/immunologist. This group of specialists has an interest in this disease and expertise in this field.
- The Academy of Pediatrics Healthy Children website provides information on how to tell the difference between colds and sinus infections.