Sinusitis: causes, symptoms, diagnosis and treatment

Types and timeline

Clinically sinusitis is often classified by duration: acute (days to a few weeks), subacute, chronic (persisting for 12 weeks or more) and recurrent (multiple episodes per year). Acute episodes are more often viral; persistent disease suggests ongoing inflammation, structural problems, or chronic infection.

Causes and contributing factors

Common causes include viral colds that obstruct sinus drainage, secondary bacterial infection, allergic rhinitis and, less commonly, fungal infection in susceptible people. Anatomical variants, nasal polyps, smoking, dental infections and impaired immune function can predispose to persistent or severe disease.

Signs, symptoms and diagnosis

Symptoms often combine nasal congestion, purulent or clear discharge, facial pain or pressure (worse when bending forward), headache, cough and diminished sense of smell. Fever may occur in acute bacterial cases. Diagnosis is usually clinical; imaging (CT) is reserved for chronic, complicated or surgical cases. Endoscopic examination and cultures may be used when infections recur or fail to respond.

Treatment and management

• Supportive care for viral sinusitis: saline irrigation, analgesics, nasal decongestants for short-term use and humidification.
• Antibiotics are used selectively for suspected bacterial infections or severe symptoms; choice and duration are guided by clinical judgment.
• Intranasal corticosteroids and antihistamines help when inflammation and allergies contribute.
• For chronic or obstructive disease, endoscopic sinus surgery can improve drainage and symptom control when medical therapy fails.

Complications are uncommon but can include orbital or intracranial spread in severe cases. Prevention emphasizes treating allergies, avoiding tobacco smoke, and prompt care for colds. For further reading or clinical guidelines consult specialist sources and local practice recommendations via the referenced links.