Call a doctor when experiencing pain or pressure in the upper face accompanied by nasal congestion or discharge, postnasal drip, or ongoing bad breath unrelated to dental problems.
Fever can be a symptom of a sinus infection or a cold. Simple congestion with a low-grade fever probably indicates a cold and may not call for medications or antibiotics. Those also experiencing facial pain or headaches may have a sinus infection.
A doctor often can treat simple sinusitis. If left undiagnosed and untreated complications of sinusitis can occur that may lead to severe medical problems and possibly death. The following complications are medical emergencies and require immediate treatment in a hospital’s emergency department.
Headache, fever, and soft tissue swelling over the frontal sinus may indicate an infection of the frontal bone, called Pott’s puffy tumor or osteomyelitis. Usually, this complication is limited to children.
Infection of the eye socket may result from ethmoid sinusitis. The eyelid may swell and become droopy. Fever and severe illness are usually present. A person with this infection may lose the ability to move the eye, and permanent– blindness may result.
Ethmoid or frontal sinusitis may also cause the formation of a blood clot in the sinus area around the front and top of the face. Symptoms may be similar to those of eye socket infection with the addition of a fixed and dilated pupil. This condition usually affects both sides of the face.
If a person experiences mild personality changes, headache, neck stiffness, high fever, altered consciousness, visual problems, or seizures, infection may have spread to the brain. Coma and even death may follow.
The diagnosis of a sinus infection is usually made based on a medical history assessment and a physical examination. Adequately distinguishing sinusitis from a simple upper respiratory infection or a common cold is important.
Sinusitis is often caused by bacteria and requires antibiotics for treatment. Sinusitis can also be caused by viruses (meaning antibiotics would not help). Upper respiratory infections and colds are viral illnesses.
Proper diagnosis of these potentially similar conditions prevents confusion as to which medications should be given. Overtreating viral infections with antibiotics can be dangerous.
In most cases, diagnosing acute sinusitis requires no tests. When testing is needed, the CT scan can clearly depict all of the paranasal sinuses, the nasal passages, and the surrounding structures.
A CT scan may indicate a sinus infection if any of these conditions is present: Air-fluid levels in one or more sinuses and total blockage in one or more sinuses. Also, thickening of the inner lining (mucosa) of the sinuses.
Mucosal thickening can occur in people without symptoms of sinusitis. Therefore, CT scan findings must be correlated with a person’s symptoms and physical examination findings to diagnose a sinus infection.