Related concepts:

Acute bacterial sinusitis, Chronic bacterial sinusitis, Subacute bacterial sinusitis

Introduction to sinusitis:

That runny nose and cough just won’t go away…

Perhaps your child has a sinus infection. Sinusitis is a common problem in children. Nevertheless, it is often over-diagnosed in children with green runny noses, and missed in children who really have a sinus infection!

What is sinusitis?

The sinuses are small empty caverns in the bony skull. They are lined by mucus membranes and connect with the nasal passages. Some sinuses are present at birth; others continue to grow and develop for the first 20 years of life.

Sinusitis is the name given when the lining of one or more of these sinuses is red, swollen, and tender, the opening is blocked, and the sinus is at least partially filled with fluid (mucus and/or pus).

Technically, every cold is also a case of viral sinusitis. However, when doctors use the term sinusitis they are usually referring to a bacterial infection in the sinuses.

Acute bacterial sinusitis has been present for less than three or four weeks; subacute bacterial sinusitis has been present for up to about ten weeks; and chronic bacterial sinusitis has been present for about ten weeks or more. The three may have different causes and treatments.

Who gets sinusitis?

Anyone can get a sinus infection. Colds or nasal allergies are usually present first. Sinus infections are also more common when there is exposure to cigarette smoke.

Children who have ear infections, GE reflux, cystic fibrosis, immune problems, deviated nasal septa, or poorly functioning cilia are more likely to develop sinus infections. Asthma and sinus infections often go together.

In addition, swimming, breathing cold dry air, or attending day care can predispose a child to sinusitis.

Boys get more sinus infections than girls.

What are the symptoms of sinusitis?

Adults and adolescents with sinusitis will often have headaches or facial tenderness to make the diagnosis clear. These are much less common in younger children. Instead, the symptoms are usually similar to a prolonged cold.

The common cold usually lasts about seven days. Within one to three days of the onset, the nasal secretions usually become thicker and perhaps yellow or green. This is a normal part of the common cold and not a reason for antibiotics.

If a child has both a cough and nasal discharge that do not improve within 10 to 14 days, this may be acute bacterial sinusitis. The nasal discharge may be clear or colored. The cough is present during the day, but is often worse during naps or at bedtime.

There may be a fever, sore throat from post-nasal drip, or bad breath.