Acute Sinusitis
Acute sinusitis is short-term inflammation of the sinus lining, usually following a viral cold and causing nasal blockage, discharge, facial pressure and reduced smell.
Key takeaways
- Most episodes are viral and improve without antibiotics; coloured mucus by itself does not prove bacterial infection.
- Symptoms lasting without improvement, severe fever with facial pain, or worsening after initial recovery raise concern for bacterial sinusitis.
- Eye swelling, visual change, severe headache or neurological symptoms require urgent assessment.
The listings below do not identify the cause of sinus symptoms; duration, severity and examination should guide treatment.
Symptom relief
Saline irrigation, fluids and appropriate pain relief may help. Intranasal corticosteroids can be useful when allergy or substantial nasal inflammation contributes. Oral or topical decongestants have contraindications and prolonged topical use can cause rebound congestion.
When antibiotics are considered
Antibiotics are reserved for presentations more likely to be bacterial or people at increased risk of complications. Migraine, dental infection and allergic rhinitis can mimic sinus pain, so persistent one-sided or recurrent symptoms deserve reassessment rather than repeated empirical courses.
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.