Pansinusitis: Chronic vs. acute, symptoms, and treatment (2023)

Pansinusitis is when all of the sinuses in the head become infected or inflamed. Usually, a sinus infection, or sinusitis, affects only one or two sinus groups.

Pansinusitis may feel like a severe sinus infection but often clears up over time without treatment. However, some cases benefit from medical treatment, such as antibiotics or antifungal medications.

In this article, learn about the causes and symptoms of pansinusitis, as well as when to see a doctor.

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Pansinusitis occurs when all of the sinuses in the head become infected.

The sinuses are hollow cavities that are located behind the cheeks, forehead, and around the nose. They are lined with mucus that helps trap germs and debris.

Germs are swept down the throat by cilia, which are tiny hairs in the sinuses. When the sinuses are working correctly, this process continuously drains mucus and unwanted substances from the nose and surrounding areas.

If a person is ill, the mucus in the sinuses may build up, preventing the cilia from working properly. The sinuses and nasal passages may swell and cause nasal congestion, which can lead to a painful sinus headache, runny nose, and stuffiness.

If the congestion continues beyond a few days, the sinuses may respond with swelling and inflammation, resulting in sinusitis. If it becomes very severe and affects all the sinuses, pansinusitis may occur.

Sinusitis and pansinusitis should not be confused with rhinitis.

Rhinitis is inflammation and swelling of the nasal passages only and does not involve the sinuses. Doctors often use the term “acute rhinitis” to describe the stuffy nose associated with a cold or allergies.

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The most common symptoms of pansinusitis include:

  • pressure, tenderness, and pain in the front of the face
  • severe nasal congestion
  • sore throat from postnasal drip
  • thick nasal discharge
  • fever
  • facial pain that radiates into the teeth
  • headache in the front of the head
  • cough
  • fatigue
  • bad breath

All cases of pansinusitis have inflamed sinuses in common. But depending on their cause and how long they last, they may be classified in different ways:

  • Acute pansinusitis: Symptoms last less than 12 weeks.
  • Chronic pansinusitis: Symptoms last longer than 12 weeks.

These infections may also fall into one of the following categories:

  • Viral pansinusitis, such as from a cold or flu virus.
  • Bacterial pansinusitis, when a bacterial infection causes it.
  • Fungal pansinusitis, when symptoms occur due to fungi or mold.
  • Allergic pansinusitis, when allergies cause it.

Pansinusitis can also occur because of a physical blockage in the nose or sinuses. An obstruction may make it harder for the sinuses to drain.

Common types of nasal blockages include:

  • a deviated septum
  • nasal polyps
  • narrowed nasal passages

Diagnosis

(Video) Sinusitis, Animation.

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A doctor can diagnose sinusitis in several ways, including:

  • discussing the symptoms and checking the sinuses for soreness or tenderness
  • looking inside the nose and sinuses
  • taking a swab of the inside of the sinuses
  • using imaging tests, such as magnetic resonance imaging (MRI) or computed tomography (CT)

For pansinusitis, a CT or MRI will likely be needed to confirm that all sinuses are affected.

Treatment for pansinusitis varies, depending on the underlying cause.

Viral pansinusitis

Viral pansinusitis often clears up in 2 weeks or less. Some over-the-counter (OTC) remedies may provide relief from bothersome symptoms.

People can try using pain relievers, decongestants, and saline nasal sprays. Gargling with salt water and baking soda can help relieve an irritated throat from postnasal drip.

Bacterial pansinusitis

A doctor will usually prescribe antibiotics to treat bacterial sinus infections if they do not clear up on their own. However, if a person takes antibiotics too frequently, they no longer work against some types of bacteria. This can make infections more dangerous and harder to treat.

To help prevent this, antibiotics should only be used for pansinusitis when a doctor believes bacteria cause the infection. The Centers for Disease Control and Protection (CDC) also states that antibiotics do not work against most minor sinus infections. They do not work in cases of viruses, fungi or allergies.

Pansinusitis is usually more severe than a minor sinus infection, however. If a sinus infection does not clear up after 2 weeks, a doctor may look more deeply into the cause.

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Green nasal discharge is not always an indicator of a sinus infection. A viral infection, such as a cold, can also cause the mucus in the nose to turn green. Significant sinus infections are more likely to have thick nasal discharge with a bad taste in the mouth.

Fungal pansinusitis

A person with fungal pansinusitis may need to take antifungal medicines if the symptoms do not clear up over time. Fungal sinus infections are more likely to occur in tropical areas and individuals with nasal polyps.

More serious fungal infections are most common in those with poorly functioning immune systems due to conditions that can include cancer and diabetes.

Allergies

A person may need allergy tests if they have an undiagnosed allergy that causes pansinusitis. If they have a known allergy, antihistamines and other OTC options can help reduce symptoms.

It can help to identify and avoid the allergen when possible. For people with seasonal allergies, many weather programs also indicate high pollen times.

It may be recommended that treatment with allergy shots, which is know as allergy immunotherapy, is given to individuals with persistent chronic sinusitis.

Blockages

In some cases, surgery may be needed to remove a blockage in the nose. A doctor can remove nasal polyps this way.

A deviated septum or narrow nasal passages can also be corrected. This is only done for chronic and recurring sinus infections.

Complications

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Most cases of pansinusitis will get better without causing any additional medical problems.

In rare cases, however, pansinusitis can lead to other complications. Medical literature gives examples of ways pansinusitis can cause other issues:

  • One case report states that an otherwise healthy 33-year-old man reported double vision after having a headache and nasal congestion for 3 weeks. The symptoms began after he swam in a pool. Doctors diagnosed pansinusitis, probably resulting from bacteria in the pool. Doctors found that one of the nerves in his skull had been temporarily paralyzed (known as palsy) as a result of the pansinusitis. Symptoms resolved after the man took antibiotics.
  • Another case report describes a 9-year-old boy who had a drooping eyelid, which is known as ptosis. Using an MRI, doctors determined that pansinusitis had caused the ptosis. After the boy was treated with antibiotics, the ptosis went away.

Some of the sinuses are located close to the brain, so severe pansinusitis could lead to rare but serious infections in the brain. A doctor will evaluate any severe sinus infection to avoid possible complications to the brain.

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It is not always possible to prevent pansinusitis, as common ailments such as the cold or flu often contribute to a sinus infection.

Sinus infections, especially pansinusitis, may be more likely to occur in people who have weakened immune systems.

A person can help prevent pansinusitis by:

  • Washing their hands thoroughly and often.
  • Getting enough rest.
  • Eating a varied and nutritious diet to strengthen the immune system.
  • Not smoking, as smoking and secondhand smoke weakens the immune system and makes sinus infections more likely.
  • Treating allergies or avoiding allergens.
  • Avoiding people who are sick with colds or the flu.
  • Seeing a doctor if cold or flu symptoms do not improve within 5 days.
  • Drinking plenty of clear fluids to help keep nasal mucus thin.
  • Using a humidifier to moisturize the air.
  • Getting a flu shot each year or as recommended by a doctor.
  • Making sure children get recommended vaccines on schedule.

Most people recover completely from pansinusitis, especially if they receive proper medical treatment.

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Serious complications are rare, but a person can still speak to a doctor about treatments to reduce symptoms, including pain and congestion.

FAQs

How is chronic pansinusitis treated? ›

Treatment
  1. Nasal corticosteroids. ...
  2. Saline nasal irrigation, with nasal sprays or solutions, reduces drainage and rinses away irritants and allergies.
  3. Oral or injected corticosteroids. ...
  4. Allergy medications. ...
  5. Aspirin desensitization treatment, if you have reactions to aspirin that cause sinusitis and nasal polyps.
16 Jul 2021

What is acute on chronic pansinusitis? ›

Pansinusitis can be acute or chronic. Acute pansinusitis usually gets better within about 10 days. Chronic pansinusitis means you have the infection for at least 12 weeks even though you're being treated for the condition.

How do you differentiate acute and chronic sinusitis? ›

Chronic sinusitis and acute sinusitis have similar signs and symptoms. But acute sinusitis is a temporary infection of the sinuses often associated with a cold. The signs and symptoms of chronic sinusitis last at least 12 weeks, but you may have several episodes of acute sinusitis before developing chronic sinusitis.

Is Pansinusitis curable? ›

Pansinusitis may feel like a severe sinus infection but often clears up over time without treatment. However, some cases benefit from medical treatment, such as antibiotics or antifungal medications.

What is best antibiotic for chronic sinus infection? ›

Treatment of Chronic Sinusitis

The antibiotics of choice include agents that cover organisms causing acute sinusitis but also cover Staphylococcus species and anaerobes. These include amoxicillin-clavulanate, cefpodoxime proxetil, cefuroxime, gatifloxacin, moxifloxacin, and levofloxacin.

Is acute Pansinusitis contagious? ›

No. Since they form inside the nose and not through an outside infection, bacterial sinus infections are not contagious. The underlying disease that caused a sinus infection—like a cold or flu—can be contagious, though.

Is paranasal sinus disease serious? ›

Paranasal sinus disease is common and on occasion can become life-threatening if not treated in a timely fashion. At birth the maxillary sinuses and ethmoid air cells are present but hypoplastic.

What are the 4 main symptoms of sinusitis? ›

Common signs and symptoms of sinusitis include:
  • Post nasal drip (mucus drips down the throat).
  • Nasal discharge (thick yellow or green discharge from nose) or stuffy nose.
  • Facial pressure (particularly around the nose, eyes, and forehead), headache and or pain in your teeth or ears.
  • Halitosis (bad breath)
  • Cough.
4 Jun 2020

Does chronic sinusitis ever go away? ›

Can chronic sinusitis go away on its own? This is unlikely. Most people who have had sinus problems for more than 12 weeks have an underlying cause which will need treatment.

How do you treat paranasal sinuses? ›

Treatment
  1. Saline nasal spray, which you spray into your nose several times a day to rinse your nasal passages.
  2. Nasal corticosteroids. ...
  3. Decongestants. ...
  4. Allergy medications. ...
  5. OTC pain relievers, such as acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others) or aspirin.
27 Aug 2021

How do you live with chronic sinusitis? ›

Avoid allergens such as animal dander, dust, pollen, smoke and mold that trigger swelling in the sinuses. Quit smoking if you do smoke and avoid any secondhand smoke. Wash your hands thoroughly with soap and water. Rinse your nasal passages with saline solution, either purchased or with a neti pot.

What causes chronic Pansinusitis? ›

The most common causes of chronic sinusitis include: A blockage that prevents the sinuses from draining: This can be due to damage to the nose or the face, nasal polyps and tumors, or because of a chronic infection. People with a deviated septum are more likely to develop chronic sinusitis.

Can chronic sinusitis heal without surgery? ›

Allergists treat the underlying medical causes of chronic sinusitis. Non-surgical treatment options include antibiotics, steroids, nasal saline irrigation, mucus-thinning agents, antihistamines, nasal decongestants, and analgesics.

When is sinusitis considered chronic? ›

Chronic sinusitis is an inflammation of the sinus or nasal passages occurring for more than 12 weeks at a time. It may present as chronic sinusitis without nasal polyps, chronic sinusitis with nasal polyps, and allergic fungal rhinosinusitis.

What are the symptoms of paranasal sinus disease? ›

Signs and Symptoms of Nasal and Paranasal Sinus Cancers
  • Nasal congestion and stuffiness that doesn't get better or even worsens.
  • Pain above or below the eyes.
  • Blockage of one side of the nose.
  • Post-nasal drip (nasal drainage in the back of the nose and throat)
  • Nosebleeds.
  • Pus draining from the nose.
19 Apr 2021

Can Pansinusitis cause dizziness? ›

Yes. One possible side effect of sinus infections is a feeling of dizziness. It might be hard to see how an infection in the sinuses has any effect on your sense of equilibrium and balance.

What is the drug of choice for chronic sinusitis? ›

Corticosteroids. Corticosteroids have powerful anti-inflammatory effects and can reduce swelling in the tissue that lines nasal passages and sinuses, making breathing easier. The anti-inflammatory effects of steroid treatment may also reduce the size of nasal polyps.

Why won't my sinus infection go away with antibiotics? ›

Why Won't My Sinus Infection Go Away with Antibiotics? There are few reasons that antibiotics may be ineffective for sinusitis. Antibiotics are only capable of killing bacteria, so inflammation from other sources can't be managed by them. Sinusitis is often a result of a viral infection like a cold or the flu.

Should I take antibiotics for chronic sinusitis? ›

Antibiotics are not needed for many sinus infections. Most sinus infections usually get better on their own without antibiotics. When antibiotics aren't needed, they won't help you, and their side effects could still cause harm. Side effects can range from mild reactions, like a rash, to more serious health problems.

What foods should you avoid if you have sinus problems? ›

Avoid dairy if you have had previous episodes of sinus infections. Also, try to avoid refined sugar as it is pro-inflammatory and increases the production of mucus. Other foods to avoid include tomatoes (contain histamines), chocolate, cheese, gluten, and fruits like bananas, which can cause congestion.

Should I go to work with acute sinusitis? ›

Do: Go to School or Work. If you're worried that you may spread sinusitis to classmates or co-workers, breathe easy. It isn't contagious. Go back to your normal activities if you feel well enough.

Is banana good for sinus? ›

As much as it is recommended to eat a banana for a healthy body, it is also advised to stay away from bananas during cold or flu. If you have sinus issues then don't eat bananas after sunset. It has a cooling nature and causes congestion, sore throat.

Is paranasal sinus disease cancerous? ›

Key Points. Paranasal sinus and nasal cavity cancer is a disease in which malignant (cancer) cells form in the tissues of the paranasal sinuses and nasal cavity. Different types of cells in the paranasal sinus and nasal cavity may become malignant.

Will a brain MRI show sinus problems? ›

Of the 263 studies examined, 65 (24.7%) demonstrated abnormalities in the paranasal sinuses. We conclude that because of its great sensitivity MRI will often detect abnormalities in the paranasal sinuses which are unrelated to the patients' presenting problems.

What happens when sinusitis doesn't go away? ›

Sinusitis won't go away at the drop of a hat. It tends to linger and, if left untreated, it can last for months. Again, it's best to take a trip to your doctor's office if your symptoms last longer than one week. Note that there is a chance that long-term sinus issues may be caused by allergens.

Can sinusitis affect your eyes? ›

Known as an orbital complication, which is quite common among sinus suffers, the infection travels to the tissue of the back of the eye. This infection then can cause pain in the eye, redness, swelling eyelids, bulging eyes, impaired eye movement and double vision.

When do you need antibiotics for sinus infection? ›

You doctor may recommend antibiotics if: You have symptoms of a bacterial infection and you have not gotten better after 10 days, even with home treatment. Your symptoms are severe, or you have other problems, such as pus forming in your sinus cavities. You have had sinusitis for 12 weeks or longer (chronic sinusitis).

Does sinus affect your ears? ›

The Sinus-Ear Connection

So sinus congestion and stuffiness can affect the pressure in your ears. Treating the congestion may help. Clogged sinuses can mean more than a stuffy nose. You can also have pain, dizziness, and that muffled-ear sensation, like you're in a descending plane.

Is chronic sinusitis serious? ›

Sinusitis, even in its chronic form, is not typically dangerous. In some cases, however, it may indicate a serious underlying condition. A doctor can help identify the cause, so see a doctor if sinus pain or pressure lasts longer than a week or two.

Is paranasal sinus disease serious? ›

Paranasal sinus disease is common and on occasion can become life-threatening if not treated in a timely fashion. At birth the maxillary sinuses and ethmoid air cells are present but hypoplastic.

Does chronic sinusitis ever go away? ›

Can chronic sinusitis go away on its own? This is unlikely. Most people who have had sinus problems for more than 12 weeks have an underlying cause which will need treatment.

How do you know if a sinus infection has spread to the brain? ›

Encephalitis: This results when the infection spreads to your brain tissue. Encephalitis may not have obvious symptoms beyond a headache, fever, or weakness. But more severe cases can lead to confusion, hallucinations, seizures, difficulty speaking, paralysis, or loss consciousness.

How do I get rid of chronic sinusitis permanently? ›

Permanent cures for chronic sinusitis and sinus headaches are sometimes possible, but it can depend on the reasons why you are affected.
...
Treatment Options for Sinusitis
  1. Painkillers.
  2. Antibiotics for bacterial infections.
  3. Mediation to reduce the inflammation.
  4. Using a humidifier or nasal spray.
  5. Drinking plenty of fluids.

What happens if chronic sinusitis goes untreated? ›

If chronic sinusitis goes untreated for a length of time, it is possible the infection can spread to vital parts of your body, including to the bones, spinal fluid, and the brain. These complications, meningitis and brain abscesses, are life-threatening and require immediate emergency surgery.

What are the signs and symptoms of chronic sinusitis? ›

Common signs of chronic sinusitis include:
  • Congestion or “fullness” in the face.
  • Blockage in one or both nasal passages.
  • Fever.
  • Runny nose.
  • Discolored postnasal drainage (drainage at the back of your throat)
  • Pus in the nasal cavity.
  • Headaches.
  • Fatigue.

What is chronic paranasal sinus disease? ›

Chronic sinusitis is a long-lasting sinus inflammation (swelling) and infection. It can linger over a period of time, typically longer than 12 weeks. The sinuses are four paired cavities (spaces) in the head. These spaces are connected by narrow channels.

How do you live with chronic sinusitis? ›

Inhaling steam from hot water helps moisturize the sinuses and can loosen mucus. Nasal irrigation using a neti pot or a bulb syringe effectively relieves congestion, and warm and cold compresses over your nose, cheeks and forehead may help too.

Can paranasal sinuses be cured? ›

Nasal cavity and paranasal sinus cancers can often be cured, especially if found early. Although curing the cancer is the primary goal of treatment, preserving the function of the nearby nerves, organs, and tissues is also very important.

Do you need antibiotics for chronic sinusitis? ›

Antibiotics are not needed for many sinus infections. Most sinus infections usually get better on their own without antibiotics. When antibiotics aren't needed, they won't help you, and their side effects could still cause harm. Side effects can range from mild reactions, like a rash, to more serious health problems.

Can chronic sinusitis heal without surgery? ›

Allergists treat the underlying medical causes of chronic sinusitis. Non-surgical treatment options include antibiotics, steroids, nasal saline irrigation, mucus-thinning agents, antihistamines, nasal decongestants, and analgesics.

What can make sinusitis worse? ›

Dry air isn't the only thing that can irritate your nose and make your sinusitis symptoms worse. Inhaling cigarette smoke, strong perfumes, pollutants or any airborne allergen that affects you can lead to further inflammation and greater sinus pressure.

Will a brain MRI show sinus problems? ›

Of the 263 studies examined, 65 (24.7%) demonstrated abnormalities in the paranasal sinuses. We conclude that because of its great sensitivity MRI will often detect abnormalities in the paranasal sinuses which are unrelated to the patients' presenting problems.

What does sphenoid sinusitis feel like? ›

The main symptom of sinusitis is a throbbing pain and pressure around the eyeball, which is made worse by bending forwards. Although the sphenoid sinuses are less frequently affected, infection in this area can cause earache, neck pain, or an ache behind the eyes, at the top of the head, or in the temples.

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