Sinus infections are common, treatable
DEAR DOCTOR: Just how risky are sinus infections? I read about a teenager who died recently after a sinus infection spread to his brain.
DEAR READER: A 13-year-old boy in Michigan who had been diagnosed with a sinus infection went on to develop severe headaches, which worsened over several weeks. An MRI found that a viral infection had spread to his brain and caused blood clots, which led to a series of strokes and ultimately his death. It’s a tragic story and alarming, considering that sinus infections are common. However, these types of complications are rare.
The sinuses are pairs of air-filled cavities located behind the lower forehead, behind the nose, on either side of the bridge of the nose and within the bony structures of the cheeks. In a healthy sinus, a thin layer of mucus catches dust, dirt or debris and, with the aid of tiny hairlike structures, clears it away. That mucus then drains into the nasal passage and winds up in the nasopharynx, which is where the very back of the nose and the throat converge. At that point, the mucus continues its journey down the esophagus and into the stomach.
A sinus infection occurs when a virus, bacterium
or fungus causes the tissues that line these cavities to become inflamed. When this happens, the flow of mucus is blocked and it begins to collect in the sinus cavity. This can cause symptoms like congestion, postnasal drip, excess and sometimes discolored (usually greenish) mucus, tooth pain, a feeling of pressure, frontal headache, fatigue and even bad breath.
Conditions with similar symptoms, like colds or allergies, can be mistaken for a sinus infection. An accurate diagnosis requires an examination of the throat, nose and sinuses. This can include a physical examination with an endoscope, X-rays or a CT scan, and a mucus culture to pinpoint the cause of infection. Antibiotics may be used when the infection is bacterial but will not help with a viral infection. Symptoms can be eased with over-thecounter antihistamines, nasal decongestant sprays and nasal saline washes. Patients are often counseled to drink plenty of fluids to help thin the mucus.
Elizabeth Ko, M.D., is an internist and primary care physician at UCLA Health.
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