Bacterial sinusitis is fairly clear cut |
You are sneezing and hacking, your nose is red, congested and blocked, and you feel awful. You have a slight fever. Is it a common cold? Sure it is, but is it a sinus infection? If it is “just a cold” then it is due to a virus. This is called viral rhinosinusitis. ( rhino refers to the nose being involved). If we do a CT scan, we often find sinus cavity changes – thick mucus – in the maxillary and ethmoid sinuses. The sinus drainage passages may be blocked. Under normal conditions this mucus is drained from the sinuses by the action of cilia. These are the tiny oars that move mucus containing bacteria, dust, pollens, etc out of the sinuses and nose. With a “bad cold”, the secretions may not be drained out fast enough or the drainage may be blocked. Therefore, steps to increase cilia movement, and remove blockage are indicated. If the mucus remains in the sinus cavity, then bacteria remain in place and can multiply. The rhinosinusitis is then converted to a sinusitis. Common bacteria that cause sinusitis are Hemophilus influenzae, Moraxcella cattarrhalis and Streptococcus pneumonia. They may be present in the nasopharynx and can be carried into the sinuses by heavy coughing and forceful nose blowing. The harder you blow the nose, the more bacteria are blown into the sinuses and ears. The more force you use to clear a blocked ear, the more bacteria you force into that ear. It is possible to take a CT scan in order to help differentiate a common cold from a sinus infection. But this is considered poor practice because the CT scan does not always give an accurate answer, and the cost is a factor. |