Understanding Childhood Sinus Infections
Sinusitis is a medical term used to describe inflammation (swelling and irritation) of one or more of the sinuses. It is a common illness in both children and adults.
Most
sinus infections are caused by a virus. This is known as acute viral sinusitis. Bacteria can also infect the sinuses, although this is less common. Bacteria cause up to 13 percent of acute sinus infections in children.
Because infections are the main cause of sinusitis, the terms "sinusitis" and "sinus infection" are often used interchangeably.
The paranasal sinuses are hollow air spaces located within the skull. They include the frontal, maxillary, ethmoid, and sphenoid sinuses. These sinuses connect to the nasal passages through an opening that allows movement of air and mucus in between the nose and sinuses.
It can take up to 20 years for the paranasal sinuses to completely develop. However, in most children, by age 12, the sinuses are almost completely developed and have reached adult proportions.
Types of Sinusitis in Children
There are a couple of different types of
sinusitis. Each type is based on how long symptoms last and what has caused the condition.
Different types of sinusitis include:
- Acute sinusitis: Diagnosed when symptoms have lasted for fewer than four weeks. There are two different subtypes:
- Acute viral sinusitis, which is caused by a virus
- Acute bacterial sinusitis, which is caused by bacteria.
- Subacute sinusitis: Symptoms lasting for 4 to 12 weeks.
- Chronic sinusitis: Symptoms lasting 12 weeks or longer, despite medical treatment.
- Recurrent sinusitis: More than three episodes of acute sinusitis separated by at least 10 days of no symptoms in a six-month period; or more than four episodes of acute sinusitis separated by at least 10 days of no symptoms in a 12-month period.
Risk Factors for Sinus Infections in Children
Because the nose and sinuses are connected, anything that causes swelling in the nose -- an infection, an allergic reaction, or another type of immune reaction -- can also affect the sinuses. This increases the risk for sinusitis.
A viral upper respiratory infection is the most common reason why a child gets a
sinus infection. Other things that increase the risk for sinus infections in children include:
- Allergies (hay fever, seasonal allergies, year-round allergies)
- An obstruction in the nose, such as a polyp or deviated septum
- Infection of the ear or throat
- Irritants such as dry air, tobacco smoke, or chlorine
- Certain medical conditions, including cystic fibrosis, primary ciliary dyskinesia, gastroesophageal reflux disease (GERD), and HIV/AIDS
- Sudden changes in pressure, such as a descent in an airplane.
Children in
daycare are also more likely to get sinus infections.
Symptoms of a Sinus Infection in Children
Signs or symptoms of an acute viral
sinus infection in children are similar to those of an upper respiratory infection. They may include:
- Nasal drainage (discharge can be clear, colored, watery, mucus-like, thin, and/or thick)
- Postnasal drip
- Nasal congestion
- Cough (can be wet or dry; occurs during the day; may be worse at night).
When sinuses are infected with bacteria, the symptoms tend to last longer and/or be more severe.
Some different options for treating children with
sinusitis include:
- Acetaminophen (Infant Tylenol®, Children's Tylenol®) or ibuprofen (Infants' Advil®, Children's Advil®) for pain relief and/or fever.
- Nasal saline for congestion or a runny nose. Irrigating the nose with a non-medicated saline solution or spray several times a day can help clear the nasal passages and decrease the need for pain medicine (see Nasal Irrigation for more information on how to irrigate a child's nose).
Decongestants, antihistamines, and nasal steroids are usually not recommended for treating symptoms of an acute sinus infection in children.
Other antibiotics that may be prescribed for bacterial sinus infections in children include:
Your child should take the antibiotics exactly as prescribed and all the medication that was prescribed. This will decrease the chances of the antibiotic not completely eliminating the infection.
How Long Does Sinusitis Last?
Most uncomplicated viral
sinus infections improve on their own within 7 to 10 days. Acute bacterial
sinusitis can also improve on its own; however, antibiotics will speed up the recovery and decrease the risk of complications in children.
Symptoms usually begin to improve within one to two days after antibiotics have been started. If symptoms have not improved within three days or get worse at any time after the antibiotics have been started, contact your healthcare provider. A different antibiotic or further testing may be needed.
Possible Complications of Sinusitis in Children
Children with acute bacterial sinusitis are at risk for a number of complications. Some of these include:
