By Gilda Morales, ANP, DC
Today’s column deals with sinusitis, a condition that is commonly misdiagnosed. It is technically an inflammation of the membranes of the sinuses, but clinically, it is diagnosed as upper respiratory symptoms that have not improved in 10 days or which worsen in 5 to 7 days. The diagnosis is based on the persistence or severity of symptoms.
Most of the time, symptoms are due to viruses, don’t last longer than 7 days, and should not be treated with antibiotics, but in some cases, the cause is bacterial, usually due to streptococcus bacteria.
The more common symptoms include a nasal discharge, congestion, fever, recent history of an upper respiratory infection, sore throat, bad breath, pain around the sinuses, either around the nose or above the eyes, ear pressure or fullness, headache, and nasal speech. The headache and facial pain may increase with leaning forward, and the sinuses may be tender when tapped.
Antibiotics are not always recommended unless the diagnosis is clear, to prevent overuse and resistance. Of course, they should be used in high-risk children who are less than two years old and attend daycare. First line treatment is amoxicillin and for high-risk children, Augmentin, for no longer than 7 days. Other than antibiotics, treatment is geared toward the symptoms—use of a humidifier, normal saline nasal sprays, and decongestants for short periods of time.