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Clinical Reference Systems: Pediatric Advisor 10.0
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Sinus Infection

DESCRIPTION (Diagnosis must be confirmed by a physician.)

A sinus infection is a bacterial infection of one of the seven sinuses that normally drain into the nose. Sinus congestion can occur without an infection if one of the sinus openings becomes blocked from a cold or hay fever.

As bacteria multiply within a sinus, pain and pressure occur above the eyebrow, behind the eye, or over the cheekbone. Other symptoms can include a profuse yellow nasal discharge, postnasal drip, a blocked nose, fever, and bad breath. A sinus infection may cause a chronic cough. Swallowing sinus secretions is normal and harmless but may lead to some nausea. Most sinus infections can be diagnosed without sinus x-rays.

HOME TREATMENT

The following treatment should reduce pain and fever within 48 hours or less.

  1. Antibiotics

    Your child needs the antibiotic prescribed by your physician. This medicine will kill bacteria that are causing the sinus infection.

    Try not to forget any of the doses. If your child goes to school or to a baby sitter, arrange for someone to give the afternoon dose. If the medicine is a liquid, use a measuring spoon to make sure that you give the right amount. Even though your child will feel better in a few days, give the antibiotic until the bottle is empty to prevent the infection from flaring up again. Do not save the antibiotic for the next illness because it loses its strength.

  2. Nasal washes

    Use warm water or saline nosedrops followed by suction or nose blowing to wash dried mucus or pus out of the nose. Do nasal washes at least four times a day or whenever your child can't breathe through the nose. If the air in your home is dry, run a humidifier.

  3. Decongestant nosedrops or spray

    To drain the sinuses, use a generic, long-acting decongestant nosedrop or spray (such as oxymetazoline). You don't need a prescription for the nosedrops or spray.

    The usual dose for adolescents is two drops or sprays per nostril twice a day. For younger cHildren use one drop or spray a day.

    Use the medicine routinely for the first 2 or 3 days of treatment. After that, don't use the spray or nosedrops unless the sinus congestion or pain recurs. Stop the drops or spray after 5 days to prevent rebound swelling.

  4. Pain-relief medicines

    Your child can take acetaminophen or ibuprofen for a few days for sinus pain or any fever over 102 degrees F (39 degrees C).

  5. Oral antihistamines

    If your child also has hay fever, he or she should take allergy medicine (antihistamine). Otherwise avoid using antihistamines because they can slow down the movement of secretions out of the sinuses.

  6. Contagiousness

    Sinus infections are not contagious. Your child can return to school or day care when he or she is feeling better and the fever is gone.

CALL YOUR CHILD'S PHYSICIAN IMMEDIATELY IF:

  • Redness or swelling occurs on the cheek, eyelid, or forehead.
  • Your child starts acting very sick.

CALL YOUR CHILD'S PHYSICIAN DURING OFFICE HOURS IF:

  • The fever or pain is not gone 48 hours after your child starts taking the antibiotic.
  • You have other questions or concerns.

Written by B.D. Schmitt, M.D., author of "Your Child's Health," Bantam Books.
Copyright 1999 Clinical Reference Systems