FORT LEE, Va. (March. 5, 2013) -- Cold temperatures and frigid forecasts are a reality now in Central Virginia, and residents have begun to experience many symptoms of winter illness such as sore throat, congestion, runny nose and cough.
The question doctors often hear is: “Is it my sinuses?”
Sinuses are actually cavities (spaces) in the skull and facial bones containing mucus – secreting tissue – which filter the air we breathe, and keep it moist and warm. The sinuses are located between the eyes, above the eyes, behind the eyes and in the cheekbones. All are lined with a layer of mucus and connect to and drain through the nose.
Any bacteria, viruses or other particles that we inhale can get into the sinuses and are trapped in the mucus lining. This can lead to irritation and swelling, called “sinusitis.”
Most of the time, sinusitis is caused by a viral infection, so antibiotics are not necessary and would not work anyway.
Symptoms such as congestion, runny nose, post-nasal drip and a pressure sensation are related to the swelling and increased mucus production caused by the irritation. Cough is a frequent symptom, often triggered by the post-nasal drip.
The best treatment for these symptoms is hydration and rest, although sometimes a humidifier, mucus breaker, or decongestant may provide short-term relief. In a small percentage of cases, sinusitis can turn into a bacterial infection, usually after 7-10 days or more of symptoms.
A typical pattern is that the congestion and runny nose seemed to start getting better, but then a patient developed fever, pain in the forehead or upper teeth, thick nasal discharge usually from one nostril or thick post-nasal drainage and bad breath.
Experts now say that these infections will likely get better on their own, and antibiotic treatment is necessary only if you have symptoms for more than 10 to 14 days.
Over the past 30 years, many of the usual bacteria that cause sinusitis have acquired resistance to many common antibiotics, first to penicillin and ampicillin, and more recently to azithromycin and sulfa drugs.
The first choice in managing bacterial sinusitis in adults is doxycycline.
Patients with frequent sinusitis should seek evaluation by their primary care manager to determine if there is an underlying cause for the recurrences such as untreated allergies or a structural condition that prevents the sinuses from draining properly.
If needed, the PCM can make a referral to an allergist or an ear, nose and throat specialist for further evaluation and treatment. Most cases of congestion, sinus pressure, runny nose and cough will get better within two weeks without any treatment. Care should be sought immediately for redness and swelling in the skin around the eye, a high fever (39 C or 102.2 F or higher), blurry/double vision, or severe headache with neck pain and/or vomiting, as these may signal a significant infection. Otherwise, a medical visit can be delayed until the symptoms are lasting longer than 10 days.
Your health care team is available at Kenner Army Health Clinic to answer any questions and can help determine if an appointment is needed.
Dr. Victor Tricarico, Kenner AHC Staff Internal Medicine Physician