Sinus Infection (or Sinusitis)

Sinus infection facts

  • A sinus infection, or sinusitis, is the result of germs multiplying in mucus that gets stuck in the open cavities behind the nose, eyes and cheeks, causing the body’s immune system to malfunction.
  • Sinus infection symptoms include severe nasal congestion, sinus headache, post nasal drip, runny nose, fever, cough and discolored nasal discharge.
  • Call our office if symptoms last longer than a week, or a fever lasts longer than 3-4 days.
  • Bacteria are the most common cause of sinus infections, but viruses and fungi can cause them as well.

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What is a sinus infection?

A sinus infection can occur when fluid builds up in the air-filled cavities (called sinuses) in the head. When fluid cannot easily pass through the sinuses, it causes the lining of the sinuses to become inflamed or infected. This causes nasal congestion, runny nose, sinus headaches, and mucus to drip down the throat (known as post nasal drip).

A sinus infection, also called sinusitis, occurs in the sinus cavities behind the nose, on each side of the bridge of the nose, behind the forehead and eyes, and between the bones of the cheeks. Sinus infections are a considerable health problem, affecting about 31 million people in the United States, according to the American College of Allergies, Asthma & Immunology.

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What causes a sinus infection?

Unlike the common cold, bacteria often cause a sinus infection, but a virus or mold can as well. These invaders cause the nasal tissues to swell, preventing the body from removing the dust, germs and particles that a person breathes in every day.

In a normal state, the sinus cavities are lined with a thin layer of mucus, a slippery gel-like fluid that traps contaminant particles. Mucus sweeps those particles through the sinuses to the throat and eventually to the stomach, where the particles proceed to be eliminated.

When the lining of the sinus cavities become inflamed or swollen, the mucus gets trapped. As germs, viruses, mold or bacteria sit there, they multiply. As they multiply, they escape or suppress the body’s natural defenses, which results in infection. When the sinuses become infected, it causes some very uncomfortable and painful symptoms, which can last from 10 days up to eight weeks.

Chronic sinusitis

Some people may be more susceptible to sinusitis due to the bone structure in their heads. Those who have narrow sinus openings, misshapen cartilage between the two nasal passages, or nasal polyps may suffer from chronic sinusitis. That means that sinus infections or symptoms can go on indefinitely and require ongoing medical attention.


Seasonal or year-long allergies can also impact the occurrence of sinusitis. Nasal passages and sinus cavities become inflamed and congested as the body tries to flush out the allergens such as molds, dust mites, pet dander, pollen, and tree and grass particles. People with chronic nasal inflammation and asthma can develop a kind of chronic sinusitis that is not caused by infection.

Other risk factors for sinusitis

Aside from inborn conditions, there are other factors that can increase the risk of a sinus infection. These include having a cold (or recently having one), the flu, seasonal allergies, smoking and exposure to second-hand smoke, and a weakened immune system caused by disease or medications.

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Sinus infection symptoms

Sinus infection symptoms are frequently mistaken as those of a bad cold. However, unlike a cold, they are often caused by bacterial infections and require treatment with antibiotics.
Sinusitis symptoms include:

    • Sinus headache.
    • Post nasal drip.
    • Nasal congestion.
    • Runny nose.
    • Discolored nasal discharge (a yellow or green color).
    • Pressure behind the eyes, cheeks or nose.
    • Tenderness of the face.
    • Sore throat.
    • Cough.
    • Pain in the teeth.
    • Tiredness.
    • Fever.
    • Bad breath.

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Diagnosing a sinus infection

If symptoms are severe and painful, if they last more than 10 days, or if they get worse after initially getting better, it is time to see a doctor. People should also make an appointment if a fever lasts more than a few days, if there is discoloration or blood in the mucus, or if symptoms continue to recur.

If the symptoms last more than two months, or if antibiotics are not working, our provider may request one or more procedures.

    • Mucus culture: samples of mucus are taken from the nose or sinuses and grown in a lab to determine whether the cause is bacteria, viral or fungal. Knowing the specific cause will enable a doctor to prescribe specific treatments or medications.
    • CT scan: a type of X-ray that presents a 3D picture of the sinuses to assess how much fluid has collected and detect any misshapen bones or abnormal growths.
    • Referral to a specialist: an ear-nose-and-throat doctor or allergist may need to examine the nose and sinuses with a tiny camera or test for known allergens.

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Sinus infection treatment

Bacterial infections persist for 7-10 days and may actually get worse after seven. A course of antibiotics has been the standard treatment for bacterial sinus infection. However, due to the overprescribing of these drugs and the fact that many bacteria are becoming resistant to antibiotics, our providers may hold off on prescribing them immediately.

Viral or fungal sinusitis infections are not treated with antibiotics. There are no treatments for viruses, but luckily, a viral sinus infection usually starts to improve after a week. A fungal infection requires an anti-fungal medication or, in the worst cases, endoscopic cleansing of the sinuses with long-term medical attention.

Using over-the-counter medications, saline rinses, drinking lots of fluids and getting a lot of rest will help soothe the symptoms.

A provider may prescribe prednisone or cortisone pills, which shrink inflamed tissue. A short, one-time course will help clear up nasal passages. However, all steroids must be used with caution and have dangerous side effects, especially with long-time use.

Over-the-counter medications can help to ease symptoms, as long as they are taken as directed:

  • Nasal decongestants in spray form can be used for up to 3-4 days to relieve congestion and runny nose. However, overuse can cause a dependent condition in which the nasal passages swell up and close.
  • Decongestants and antihistamines in pill form should only be used on advice from a doctor. Some contain drying agents that can thicken the mucus.
  • Corticosteroids in spray form help reverse the inflammation. Because a normal dose is not absorbed into the blood stream, these sprays can safely be used for a long time.

Homeopathic solutions serve as sinus infection treatments. These include putting a warm compress over the nose and forehead to relieve pressure and breathing in steam from a shower or a bowl of hot water. Nasal rinses using a neti pot or saline spray help moisturize the passages and flush mucus out.

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