Sinusitis

What is sinusitis and how can I tell the difference between sinusitis and a cold?

When your child has a viral cold or hay fever, the linings of the nose and sinus cavities swell up and produce more fluid than usual. This is why the nose gets congested and "runny". Most of the time the 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, sinuses fill with fluid and bacteria get trapped inside and grow there. This is bacterial sinusitis.

Cold or infection?

It is often difficult to tell if an illness is just a viral cold or if it is complicated by a bacterial infection of the sinuses.

Generally viral colds have the following characteristics:

Signs and symptoms that your child may have bacterial sinusitis include:

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 pediatrician immediately:

Treating bacterial sinusitis

Following are treatments for bacterial sinusitis and related symptoms:

Sinusitis. If your child has bacterial sinusitis, your pediatrician may prescribe an antibiotic for at least 10 days. Once your child is on the medication, 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 medications too early could cause the infection to return.

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 medication or need to be re-examined.

Headache or sinus pain. To treat headache or sinus pain, try placing a warm washcloth on your child's face for a few minutes at a time. Pain medications such as acetaminophen or ibuprofen may also help. (However, do not give your child aspirin. It has been associated with a rare but potentially fatal disease called Reye syndrome.)

Nasal congestion. If the secretions in your child's nose are especially thick, your pediatrician may recommend that you help drain them with saline nose drops. These are available without a prescription or can be made at home by adding 1/4 teaspoon of table salt to an 8-ounce cup of water. Unless advised by your pediatrician, do not use nose drops that contain medications because they can be absorbed in amounts that can cause side effects.

Placing a cool-mist humidifier in your child's room may help keep your child more comfortable. Clean and dry the humidifier daily to prevent bacteria or mold from growing in it (follow the instructions that came with the humidifier). Hot water vaporizers are not recommended because they can cause scalds or burns.