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Sinusitis: Online Diagnosis and Treatment

Sinusitis, also known as a sinus infection or rhinosinusitis, typically occurs after a cold or allergies cause fluid to accumulate in the sinuses and become infected. Telehealth for sinusitis is an ideal solution.

Scheduling a consultation with a virtual doctor on the Telegra MD telehealth platform for sinusitis symptoms is simple and convenient. You will receive a diagnosis, a treatment protocol, and an appropriate online prescription to treat your sinusitis symptoms. Telehealth for sinusitis treatment makes it easy to consult with a virtual doctor and receive sinusitis treatment quickly and easily, even if you don’t have insurance.

Every year, approximately 30 million Americans suffer from sinusitis, according to the Centers for Disease Control and Prevention. This equates to approximately 16 million office visits per year. Sinusitis is most common in adults aged 45 to 64 years. Sinusitis is more common in women than in men because of their increased exposure to children.1

Sinusitis can cause painful headaches, congestion, a sore throat, and nausea from post-nasal drainage. Antibiotics are used to treat bacterial sinus infections. Viral sinus infections can be treated with medications that reduce symptoms and decrease inflammation.

What Is Sinusitis?

Sinusitis and rhinosinusitis refer to inflammation in the sinuses and nasal cavity. The sinuses are cavities in the facial bones. Sinuses are lined with mucous membranes that produce mucus, a substance that cleans the nose and sinuses. Microscopic, hair-like structures called cilia beat the mucus and push it toward the sinus openings. The sinuses drain into the nasal cavity.

When you have allergies or a viral infection, the inner lining of the sinuses may become inflamed and swollen. If the antrum, or opening of the sinuses, becomes blocked, the sinuses cannot drain, and they fill with mucus. This can cause pressure and facial pain.2 Mucus in the sinuses can become secondarily infected with bacteria. As inflammation and bacteria increase in the sinuses, mucus becomes thickened and discolored.

Sinusitis is considered to be acute if your symptoms last less than four weeks, subacute if they last four to 12 weeks, and chronic if you have sinus symptoms for longer than 12 weeks.3 Viral infections cause most sinusitis, but bacterial and fungal infections also occur.4

Can Sinusitis Be Treated Through Telehealth?

Yes, sinusitis can be treated through telehealth. Sinusitis is typically a clinical diagnosis based on your symptoms. If you have symptoms of a sinus infection that last more than 10 days, get worse, or are severe, you may have a bacterial sinus infection. Consulting with a virtual doctor to discuss your sinusitis symptoms is a convenient way to get an accurate diagnosis and sinusitis treatment.

Infectious particles in the air

How Do You Get Sinusitis?

Most acute rhinosinusitis (sinus infections) is due to viral infections. These viruses are the same ones that cause “common cold” symptoms. The process that can lead to a viral sinus infection begins when viral particles come in contact with the conjunctiva of the eye or the lining of the nose.

Touching contaminated surfaces and then touching your eyes or nose is one way to get an infection. Another is when people cough or sneeze and expel droplets into the air. Some may land on your eye or nose, infecting you.

The most common viruses that cause colds and sinus infections are rhinoviruses, influenza viruses, and parainfluenza viruses. These viruses replicate almost immediately and usually cause symptoms the next day.

Blowing your nose is thought to cause a reflux of infected mucus into the sinuses. Infection in the sinuses causes inflammation and swelling of the mucosal lining in the sinuses. Inflammation causes an increase in white blood cells, proteins, and fluids in the sinuses. It can also cause ciliary function to be impaired. Together, these changes cause fluid to accumulate and sit in the sinuses.

In about 10-12% of cases, sinuses become infected with bacteria.5 Having a viral infection or allergies can increase the risk of developing bacterial sinusitis. Other factors that increase the risk of a secondary bacterial infection include:6,7

  • Obstructions, such as a deviated septum, foreign bodies, or nasal polyps
  • Impaired mucus clearance from the sinuses
  • Impaired immune function, diabetes mellitus
  • Dental infections
  • Cigarette smoking
  • Altitude changes
  • Swimming or diving
  • Exposure to pollutants or airborne chemicals

Because it is difficult to differentiate bacterial and viral sinusitis, many doctors will use length of symptoms as a factor when determining whether to treat sinusitis as a bacterial infection. The American Academy of Otolaryngology-Head and Neck Surgery recommends considering a diagnosis of bacterial sinusitis if symptoms continue after 10 to 14 days or if symptoms worsen after 5 to 7 days. It is important to note that viral causes of sinusitis can cause symptoms lasting from 1 to 33 days, though most people are feeling better by 7 to 10 days.8

A woman with inflamed sinuses

What Are Common Symptoms of Sinusitis?

Sinusitis symptoms stem from the collection and poor drainage of infected mucus in the sinus and nasal cavities. Common sinusitis symptoms include:6

  • Facial pain and pressure
  • Sore throat
  • Headache
  • Nasal congestion
  • Thick yellow or green nasal discharge
  • Metallic or bad taste
  • Fever
  • Cough
  • Sleep disturbances
  • Tooth discomfort

Chronic sinusitis is an infection that lasts longer than 12 weeks. The symptoms are persistent, but usually milder than with acute sinusitis. Symptoms of chronic sinusitis include:

  • Nasal congestion
  • Sinus pain and pressure
  • Postnasal drip
  • Nasal discharge
  • Decreased sense of taste and smell
  • Yellow or green nasal discharge

Symptoms that are more common with bacterial sinusitis include:7

  • Yellow or green nasal discharge
  • Facial pain on one side
  • Upper jaw tooth pain
  • Worsening symptoms after initial improvement

Any illness or irritant that causes inflammation in the sinuses can cause sinus pain and pressure. Instead of a sinus infection, you may have severe allergies, exposure to environmental irritants, structural abnormalities in the nose or sinuses, or nasal polyps causing your symptoms. Using telemedicine for sinusitis, your online doctor can evaluate your symptoms, make an online sinusitis diagnosis, and provide a treatment plan for sinusitis or another condition.

What Are the Less Common Symptoms of Sinusitis?

Chronic cough is less commonly associated with adult sinusitis but is common in children with a sinus infection. Other less common symptoms of sinusitis include:

  • A decrease or loss of smell or taste: Inflammation and swelling in the sinuses make it more difficult for odor and taste molecules to reach smell and taste receptors.
  • Tooth pain: The maxillary sinuses are close to the roots of the upper jaw teeth. Inflammation of the maxillary sinuses can cause pain referred to the teeth.
  • Fatigue: Difficulty breathing and inflammation can cause sleep problems and chronic fatigue.
  • Ear pain or pressure: Infection and inflammation in the sinuses can extend to the Eustachian tubes. These tubes equalize pressure between the middle ear and the throat. When the Eustachian tubes swell shot, pressure can build in the middle ear.
  • Bad breath (halitosis): Nasal congestion and bacterial infections can cause mouth drying and bad breath.
  • Facial swelling: Sinus inflammation can cause swelling around the sinuses and eyes.

Very rarely, sinus infections can spread outside of the sinuses to the eyes, bones, or the brain. These serious complications need emergency evaluation and treatment.

When Should You See a Doctor for Sinusitis?

If you have nasal congestion and facial pain or pressure that has persisted or worsened after a week, schedule a consultation with a virtual doctor to quickly determine a treatment plan that can improve your symptoms.

Schedule an appointment with a doctor at any time if you have any of the following:

  • History of sinus problems
  • A persistent fever
  • Headache that worsens or persists
  • Medical conditions that may increase your risk for a serious infection
  • Signs of a sinus infection
  • Symptoms that last longer than 7 to 10 days
  • Symptoms that worsen after initially improving

Telehealth for sinusitis treatment is a great option. Imaging of the sinuses is not typically recommended or needed for diagnosis. Sinusitis diagnoses are made based on clinical symptoms. Complete the medical intake form on the Telegra MD telehealth platform for sinusitis treatment and schedule a convenient consultation with an online doctor to receive a diagnosis and treatment for sinusitis.

Seek treatment with an in-person doctor if you have the following symptoms:

  • Fever higher than 102°F
  • Swelling or redness around one or both eyes
  • Severe headache
  • Sudden pain in the face or head
  • Vision changes
  • Trouble thinking clearly
  • Neck stiffness

Finding a virtual doctor on call is easy in this age of telemedicine. A virtual doctor can evaluate your symptoms and provide an online sinusitis diagnosis. Many online doctors who treat sinusitis provide 24-hour access, which means you can expect doctor access whenever you need it. If your online doctor believes that you have bacterial sinusitis and need an antibiotic or severe allergies that need treatment, they can send an online prescription to an online or local pharmacy.

Are Some People at Increased Risk of Sinusitis?

Some people are at an increased risk of sinusitis. Known risk factors for sinusitis include: 8

  • Older age
  • Air travel
  • Smoking
  • Deep sea diving
  • Swimming
  • Asthma
  • Allergies
  • Dental disease
  • Immunodeficiency
  • Trauma
A amn sneezing

How Do You Diagnose Sinusitis?

Sinusitis is a clinical diagnosis. This means that your doctor will make a diagnosis based on your signs and symptoms, not based on imaging and lab results. Unfortunately, there are no specific signs or symptoms that definitively lead to a sinusitis diagnosis., rather, it is more of a clinical impression based on experience.

Imaging, lab work and a referral to a specialist are typically considered when your symptoms persist or worsen with appropriate antibiotic therapy, or your symptoms persist after taking two courses of antibiotic treatment. Other reasons for a more detailed investigation include if you develop recurrent or chronic infections, have risk factors for more severe infections, develop complications, or your diagnosis is unclear.

How do You Treat Sinusitis?

Treatment for sinusitis varies based on whether your doctor thinks the infectious cause is viral or bacterial. Regardless, the goal of treatment is to eradicate the infection, decrease the duration and severity of your symptoms, and prevent complications.

Treatment guidelines suggest using the following medications as a treatment plan for sinusitis:9

  • Topical intranasal steroids can decrease swelling and inflammation.
  • Saline nose drops can loosen mucus and clean the nose.
  • Analgesics, such as Tylenol or Ibuprofen, can relieve headache and pain symptoms.
  • Antibiotics may be recommended if symptoms persist for longer than 7-10 days without improving.
  • Nasal decongestants can relieve symptoms but should not be used longer than instructed to prevent rebound congestion.  
  • Oral antihistamines may help decrease secretions and sneezing. However, they may also cause excessive dryness of the nose and sinuses and worsen symptoms.

What Are Some Common Medications Used to Treat Sinusitis?

Antibiotics are not helpful in treating viral or fungal infections. Amoxicillin, with or without clavulanate, is recommended as a first-line treatment for acute bacterial sinusitis. For people with a penicillin allergy, doxycycline, levofloxacin or moxifloxacin are alternatives.

Because of concerns about antibiotic resistance, your doctor may offer watchful waiting and symptomatic treatment as an option to antibiotics. This is because most sinus infections are viral and viruses do not respond to antibiotic treatment.

A person talking to a telehealth doctor

Can You Prevent Sinusitis?

Maintaining mucus flow through the sinuses can help prevent sinusitis. Steps you can take to protect your sinuses from inflammation and infection include:

  • Avoid pollutants and allergens
  • Avoid touching your face and eyes
  • Rinse your sinuses with a saline solution
  • Stay hydrated
  • Stop smoking
  • Treat medical conditions such as gastroesophageal reflux disease, severe allergies, or enlarged tonsils and adenoids
  • Use a humidifier to thin secretions

If you develop symptoms consistent with sinusitis, schedule an appointment with a virtual doctor on the Telegra MD platform to receive an online diagnosis and treatment plan for sinusitis.

Disclaimer

While we strive to always provide accurate, current, and safe advice in all of our articles and guides, it’s important to stress that they are no substitute for medical advice from a doctor or healthcare provider. You should always consult a practicing professional who can diagnose your specific case. The content we’ve included in this guide is merely meant to be informational and does not constitute medical advice.

References

1. Blackwell DL, Lucas JW, Clarke TC. Summary health statistics for U.S. adults: national health interview survey, 2012. Vital Health Stat 10. 2014 Feb;(260):1-161. PMID: 24819891.

2. Battisti AS, Modi P, Pangia J. Sinusitis. [Updated 2023 Mar 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470383/

3. Lanza DC, Kennedy DW. Adult rhinosinusitis defined. Otolaryngol Head Neck Surg. 1997;117(3 pt 2):S1-7.

4. Naclerio RM, Bachert C, Baraniuk JN. Pathophysiology of nasal congestion. Int J Gen Med. 2010 Apr 8;3:47-57. doi: 10.2147/ijgm.s8088. PMID: 20463823; PMCID: PMC2866558.

5. Gonzales R, Bartlett JG, Besser RE, Cooper RJ, Hickner JM, Hoffman JR, Sande MA. Principles of appropriate antibiotic use for treatment of acute respiratory tract infections in adults: background, specific aims, and methods. Ann Intern Med. 2001 Mar 20;134(6):479-86. doi: 10.7326/0003-4819-134-6-200103200-00013. PMID: 11255524.

6. Fokkens WJ, Lund VJ, Mullol J, Bachert C, Alobid I, Baroody F, Cohen N, Cervin A, Douglas R, Gevaert P, Georgalas C, Goossens H, Harvey R, Hellings P, Hopkins C, Jones N, Joos G, Kalogjera L, Kern B, Kowalski M, Price D, Riechelmann H, Schlosser R, Senior B, Thomas M, Toskala E, Voegels R, Wang de Y, Wormald PJ. EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012. A summary for otorhinolaryngologists. Rhinology. 2012 Mar;50(1):1-12. doi: 10.4193/Rhino12.000. PMID: 22469599.

7. Scheid DC, Hamm RM. Acute bacterial rhinosinusitis in adults: part I. Evaluation. Am Fam Physician. 2004 Nov 1;70(9):1685-92. Erratum in: Am Fam Physician. 2006 Jan 1;73(1):33. PMID: 15554486.

8. Patal AM, Hwang PH. Acute sinusitis and rhinosinusitis in adults: Clinical manifestations and diagnosis. UptoDate. 2022.

9. Rosenfeld RM, Piccirillo JF, Chandrasekhar SS, Brook I, Ashok Kumar K, Kramper M, Orlandi RR, Palmer JN, Patel ZM, Peters A, Walsh SA, Corrigan MD. Clinical practice guideline (update): adult sinusitis. Otolaryngol Head Neck Surg. 2015 Apr;152(2 Suppl):S1-S39. doi: 10.1177/0194599815572097. PMID: 25832968.

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