Acute Bacterial Sinusitis
Acute bacterial sinusitis is infection of the sinus cavities, usually considered when cold-like symptoms persist without improvement, become severe or worsen after initially easing.
Key takeaways
- Coloured mucus alone does not prove a bacterial infection or a need for antibiotics.
- Duration and pattern matter: prolonged symptoms, severe fever with facial pain, or “double worsening” raise suspicion.
- Eye swelling, visual change, severe headache or neurological symptoms can signal a rare complication.
The listings below do not diagnose bacterial sinusitis; assessment should determine whether antimicrobial treatment is justified.
Distinguishing it from a viral illness
Nasal blockage, facial pressure and discharge occur in both viral and bacterial sinusitis. A clinician considers how long symptoms have lasted, their severity and whether they worsened after a brief recovery. Dental infection, migraine and allergy can produce similar facial symptoms.
Where medicines fit
Saline irrigation and appropriate pain relief may ease symptoms. Antibiotics are reserved for presentations likely to be bacterial or people at higher risk of complications; selection depends on allergy history, recent antibiotics and clinical guidance. Decongestants are not suitable for everyone.
When to seek urgent care
Seek urgent assessment for swelling around an eye, reduced or double vision, severe frontal headache, neck stiffness, confusion, weakness, repeated vomiting or rapidly worsening facial swelling.