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Sinus Infections

By Heather L. Zimmerman, M.D.

Sinus Infections image

When your child has nasal congestion and drainage, you may be worried that a sinus infection has developed. Sinusitis is a bacterial infection of one or more of the seven sinuses that normally drain into the nose.

Symptoms of Sinus Infections

  • Significant nasal congestion, often with profuse yellow drainage
  • Postnasal drip
  • Facial pain or pressure, which can cause headaches
  • Cough
  • Fever
  • Bad breath
  • Nausea from swallowing nasal secretions

The tricky thing about these symptoms is that most of them can also occur with a viral upper respiratory infection (URI), or common cold, and this is actually much more common than sinusitis. Despite the old wive’s tale that yellow-green, thick nasal drainage always means sinus infection, this is not the case and commonly occurs with a URI. One thing that can help distinguish between the two is the duration of symptoms. Viral URIs usually last about 7-10 days. Your child’s physician may diagnose sinusitis if the cold-like symptoms have lasted more than 10-14 days, especially if they seem to be worsening rather than gradually getting better.

If you are worried that your child has a sinus infection, you may want to make an appointment to see his physician. This diagnosis is usually made clinically, although some doctors use imaging studies such an x-ray or CT scan to gain additional information. If your child’s doctor does diagnose a bacterial sinusitis, antibiotics will be prescribed and are an important part of the treatment.

In-home Treatments of Sinus Infections

Boys Town Pediatrics also suggests the following at-home treatments to help your child be more comfortable:

  • Use the antibiotics as prescribed. Do not miss any doses, and complete the entire prescription even if your child begins to feel better. This is very important to avoid the development of resistant bacteria.
  • Wash dried mucus from the nose using warm water or saline nosedrops 4 times or more each day.
  • Use a humidifier if the air in your home is dry.
  • Give acetaminophen or ibuprofen for sinus pressure, as well as fever.
  • If your child is over 4 years old, an over-the-counter decongestant may be helpful. Your doctor may also prescribe a nasal steroid to decrease inflammation and mucus production.

A sinus infection is not contagious. Your child can return to school or other activities when there is no longer a fever present and he or she begins to feel better.

If your child's fever is not gone within 48 hours of taking the first dose of antibiotics or you have other questions, contact your child's physician during office hours. However, if your child experiences redness or swelling around the cheek, on the eyelid or on the forehead, or he or she starts acting very sick, contact a physician immediately.​