Acute sinusitis

Diagnosis

Your doctor may ask about your symptoms and perform a physical examination, which may include feeling for painful spots on your face and nose and examining the inside of your nose. Based on this examination, your doctor can typically make a diagnosis without the need for additional tests. However, in some cases, additional techniques may be used to rule out other illnesses and confirm a diagnosis of acute sinusitis.

• Nasal endoscopy. Your doctor can see within your sinuses by inserting an endoscope via your nose, which is a small, flexible tube with a fiber–optic light.
• Imaging studies. Your sinuses and nasal area are visible in detail on a computed tomography (CT) scan. Imaging tests could be useful in detecting anomalies or potential problems, while they are typically not advised for uncomplicated acute sinusitis.
• Nasal and sinus samples. For the most part, lab testing is not required to diagnose acute sinusitis. Nevertheless, tissue samples (cultures) from your nose or sinuses may be used to assist in identifying the reason, such as a bacterial infection, if the illness is not improving after therapy or is getting worse.
• Allergy testing. Your doctor will advise an allergy skin test if they suspect allergies are to blame for your severe sinusitis. The skin test is a quick and safe way to identify the allergen responsible for your nasal flare–ups.
  

Treatment

Acute sinusitis cases typically resolve on their own. Usually, using self–care methods is enough to reduce symptoms. 

Treatments to manage symptoms

Your doctor might suggest the following therapies to relieve sinusitis symptoms: 

• Saline nasal spray: which you use to flush your nasal passages many times each day by spraying it into your nose.
• Nasal corticosteroids: Inflammation is treated and prevented by using these nasal sprays. Fluticasone, budesonide, mometasone, and beclomethasone are a few examples.
• Decongestants: These drugs come in both over–the–counter (OTC) and prescription liquids, pills, and nasal spray forms. Use nasal decongestants for a brief period of time. If not, they could trigger rebound congestion, which is a recurrence of even worse congestion.
• Allergy medications: If allergies are the cause of your sinusitis, taking allergy medicines may help reduce allergy symptoms.
• OTC pain relievers: aspirin, ibuprofen, or acetaminophen, or ibuprofen. 

Give aspirin to kids or teenagers with caution. Although aspirin is safe to use in children above the age of three, it should never be administered to adolescents or teenagers who are experiencing flu–like symptoms or chickenpox. This is because aspirin has been connected to Reye’s syndrome in these children, an uncommon but potentially fatal illness.

Antibiotics

Acute sinusitis is often caused by a virus and not a bacterial infection, so using antibiotics is not usually necessary. Even if you have bacterial acute sinusitis, it may resolve on its own, so your doctor may choose to monitor your condition before recommending antibiotics. However, if your symptoms are severe, getting worse, or chronic, antibiotics may be necessary. It is important to complete the full course of antibiotics prescribed by your doctor, even if you start feeling better. If you stop taking them too soon, your symptoms may return.

Immunotherapy

Immunotherapy (allergy shots) that lessen the body’s response to particular allergens may help treat your symptoms if allergies are a factor in your sinusitis.