Richmond’s Sinus and Allergy Specialists

Acute Sinusitis

Do I Have Sinusitis?

If you have had a cold for longer than a week, you may have sinusitis.  Most sinus infections begin with a cold – nasal congestion, drainage, and sometimes a low grade fever. After a few days, the nasal drainage becomes discolored and thick, and you may develop headaches, pain or pressure around your eyes, or pain in your upper teeth. If these symptoms are getting worse after a week, or have not improved within ten days, you probably have acute bacterial sinusitis.  Your physician can prescribe antibiotics and other medications to speed your recovery.

  • Do you have facial pain or pressure?
  • Nasal congestion or loss of smell?
  • Thick, yellow-green nasal drainage?
  • A cold lasting longer than a week?

What is Acute Sinusitis?

Acute sinusitis is a bacterial infection of the sinus cavities that surround the nose and eyes. Sinus infections are usually diagnosed when nasal congestion, facial pain or thick, yellow or green nasal drainage lasts longer than one week.  Your physician may confirm sinusitis by observing redness or pus in the nose, or demonstrating tenderness over your sinuses during examination.  A detailed endoscopic examination of your nose by an ENT specialist increases the probability of seeing infection draining from your sinuses, and offers the opportunity to obtain a culture, for better selection of antibiotics.  CT scans may be recommended for recurrent, persistent or complicated cases of sinusitis that may benefit from surgery.  Plane x-rays of the sinuses are no longer recommended.

Read more about the diagnosis of sinusitis

Is it Serious?

Acute bacterial sinusitis is the 5th most common infection in the United States.  More than 20 million adults are treated annually, with a direct cost of over $3 billion, not to mention tens of millions of sick days and lost productivity.  In rare cases, acute sinusitis can result in more serious bacterial infections that endanger the brain or eye.1

How do I Treat Sinusitis?

Acute sinusitis will usually resolve without treatment, but saline nose washes, decongestants and pain relievers can help with your symptoms. Antibiotics have been shown to shorten the course of acute sinusitis by killing the bacteria that cause inflammation. Nasal steroids shorten the course of sinusitis by reducing the inflammation. If you have chronic, recurrent or severe sinus infections, balloon dilation and endoscopic sinus surgery may offer prompt relief and reduced frequency of infections.

Read more on sinus treatment


1 Rosenfeld RM, Andes D, Bhattacharyya N, et al. Clinical practice guideline: adult sinusitis.   Otolaryngol Head Neck Surg. 2007 Sep;137(3 Suppl):S1-31.

Wald ER, Applegate KE, Bordley C, et al. Clinical practice guideline for the diagnosis and management of acute bacterial sinusitis in children aged 1 to 18 years.   Pediatrics. 2013 Jul;132(1):e262-80.