Sinus symptoms are very common during a cold or flu, but in most of these cases they are due to the effects of the infecting virus and resolve when the infection does. It is important to differentiate between inflamed sinuses associated with cold or flu virus and sinusitis caused by bacteria. With true acute bacterial sinusitis, the signs and symptoms typically have the following course:
• Nasal congestion and discharge comes first and is typically thick with pus that is yellowish to yellow-green.
• Pain in the teeth is increased by bending over. Symptoms may vary, however, depending on the sinuses involved.
• Symptoms continue for 10 days or more after the start of a cold or flu.
• They worsen after 5 - 7 days, or they return after initial improvement in a cold (called double sickening).
Other symptoms of acute sinusitis that usually occur in adults include:
• Severe headache and pain or pressure in specific areas in the face -- eyes may be red, bulging or painful eyes if the sinus infection occurs around the eyes; in some cases, patients may also have double vision and even temporary vision loss
• A persistent cough (particularly during the day)
• Fever
• Fatigue (from lack of good rest)
• Lack of response to decongestants or antihistamines
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Sneezing, sore throat, and muscle aches may be present, but they are rarely caused by sinusitis itself. Muscle aches may be caused by fever, sore throat by post-nasal drip, and sneezing from cold or allergies.
Symptoms in Children. Children are most likely to develop infection in the ethmoid sinuses, located between the eyes. Children with sinusitis are also less likely to experience facial pain over the affected sinus and headache, which are the primary signs in adults. Symptoms of bacterial sinusitis may be less specific than in adults and include:
• Persistent nasal discharge (of any type) and day time cough for more than 10 days, or
• Severe symptoms last for at least 3 - 4 days in a row and include thick, greenish nasal discharge plus a fever of at least 102 degrees F.
Other symptoms in children may include:
• Irritability
• Vomiting
• Gagging on mucus
• Cough
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