Sinusitis is an inflammation of the lining of the nose and sinuses. It often occurs after a
cold or with allergies.
When your child has a cold or an allergy, like
hay fever, the linings of the nose and sinus cavities swell up and create more fluid than usual. This is why the nose may become congested and runny from nasal discharge.
How do sinus infections usually start?
Most of the time sinusitis swelling disappears by itself as the cold or allergy goes away. However, if the swelling does not go away, the openings that normally allow the sinuses to drain into the back of the nose get blocked and the sinuses fill with fluid.
Because the sinuses are blocked and cannot drain properly, bacteria are trapped inside and grow there. This causes a secondary infection (sinus infection). Blowing the nose and sniffing too much can push bacteria from the back of the nose into the sinuses and make the infection worse.How do I know if my child has sinusitis or a cold?
At first it may be difficult to know if your child only has a cold, or if they have developed bacterial sinusitis. Here are signs and symptoms of a cold and bacterial sinusitis that will help your child's doctor decide how to treat your child.
Signs & symptoms of
a cold are different for each child and may include:
Stuffy, runny nose (clear mucus in your child's nose may turn yellow or green after 3 or 4 days)
Sneezing
Coughing
Watery eyes
Eating more slowly or not feeling hungry
Sore throat
Irritable mood
Fever is rare. If there is fever, it may come at the start of a cold but then go away.
Colds usually last 7 days, but they can last longer. Children can get one cold right after another.
Signs & symptoms of
bacterial sinusitis are different for each child and may include:
Cold symptoms (nasal discharge, daytime cough or both) lasting more than 10 days without improving. Thick yellow nasal discharge and a fever that lasts 3 or 4 days.
A severe
headache behind or around the eyes that gets worse when bending over.
Swelling and dark circles around the eyes, especially in the morning.
Persistent bad breath along with cold symptoms (However, this also could be from a sore throat or a sign that your child is not brushing their teeth.)
Exam & tests to diagnose sinusitis & sinus infections
It may be difficult to tell a sinus infection from a cold, especially in the first few days of the illness. Your child's doctor will most likely be able to tell if your child has bacterial sinusitis after examining your child and learning about the progression of symptoms.
In older children, if your child's doctor is worried the infection is spreading beyond the sinuses, they may order computed tomographic (CT) scans to confirm the diagnosis.
How is sinusitis treated?
If your child's doctor thinks your child has sinusitis, they may prescribe an antibiotic. Once your child is on the medicine, symptoms should start to go away over the next 2 to 3 days—the nasal discharge will clear and the cough will improve. Even though your child may seem better, continue to give the antibiotics for the prescribed length of time. Ending the antibiotic early could cause the infection to return.
When sinusitis is diagnosed in children with cold symptoms (viral infection) lasting more than 10 days without improving, some doctors may choose to continue observation for another few days. If your child's symptoms worsen during this time or do not improve after 3 days, antibiotics should be started.
If your child's symptoms show no improvement 2 to 3 days after starting the antibiotics, talk with your pediatrician. Your child might need a different medicine or need to be re-examined.
How to ease the symptoms of sinus pain
To treat sinus headache
Try placing a warm washcloth on your child's face for a few minutes at a time.
Pain medicine such as acetaminophen or ibuprofen may also help.
Never give aspirin to your child.
To relieve a stuffy nose
Use saline (saltwater) nose drops to help thin mucus and make breathing and feeding easier. Ask your child's doctor about which ones to use. For babies, you can use a suction bulb to help gently suction the mucus. You can also
make your own saline solution by adding 1/2 teaspoon (2.5 ml) of salt to 1 cup (8 ounces) of water. Boil the water for 15 minutes to sterilize it, but make sure it cools off before using it.
Use a
cool-mist humidifier or vaporizer to help add moisture to the air. This may help clear your child's nasal passages. Be sure to clean the humidifier or vaporizer as recommended by the manufacturer.
When to call the pediatrician
In very rare cases, a bacterial sinus infection may spread to the eye or the central nervous system (the brain).
If your child has the following symptoms, call your child's doctor right away:
Swelling and/or redness around the eyes, not just in the morning but all day
Severe headache and/or pain in the back of the neck
Persistent vomiting
Sensitivity to light
Increasing irritability
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