Do I Have a Sinus Infection? Basics on Sinusitis

Diagnosis, Symptoms, and Treatment of a Sinus Infection

What is sinusitis?. Colin Anderson/Stockbyte

Sinusitis is a common problem and in any given year affects about 12 percent of the adult population. In addition to headache and facial pain, people with sinusitis may also describe dental pain, ear pain, fever, fatigue, bad breath, or cough.

Interestingly, it can be also be erroneously diagnosed when a person is really suffering from a migraine.

Causes of a Sinus Infection

There are a number of potential causes of sinusitis including:

  • Allergens
  • Environmental irritants
  • Infections caused by viruses, bacteria, or fungi

Viral causes of sinusitis are the most common, accounting for 90 to 98 percent of all infections, whereas bacterial causes account for about 2 to 10 percent.

Symptoms that your infection may be bacterial include:

  • If your symptoms like headache, facial pain, nasal discharge, and/or fever are lasting more than 10 days and are not improving.
  • If you have severe symptoms or a high fever (≥102°F) and purulent (pus-like) discharge from your nose or facial pain that has been lasting for 3 to 4 days since the beginning of your illness.
  • If you had "common cold" symptoms for 5 to 6 days like nasal or sinus congestion that started to improve and then worsened. For instance, if you develop a new fever or headache just when you started to feel better.

Diagnosis of a Sinus Infection

When diagnosing you with a sinus infection, your doctor will  ask you questions and perform a physical examination.

Primary care doctors or general practitioners do not typically test for a sinus infection by taking a culture from your sinuses (through your nose) - known as direct sinus aspiration. This, as well as CT imaging of the sinuses, may be done by a specialist, like an ear-nose-throat specialist (ENT), if you have recurrent or chronic sinusitis or have a complicated infection.

Treatment of a Sinus Infection

Since the majority of cases of sinusitis are viral, antibiotics are not usually indicated (since they are not effective against viruses, only bacteria).

If by a small chance you do have a bacterial cause for your sinus pain, your doctor will prescribe an antibiotic, like Augmentin (amoxicillin/clavulanic acid) for 5 to 7 days. If you have an allergy to Augmentin, a history of prior infections, or are not improving on your first course of Augmentin, your doctor will consider a different antibiotic.

If your doctor rules out a bacterial infection, the good news is that there are simple therapies that can ease your symptoms until your body naturally fights off the virus. Your doctor may recommend:

Rarely sinusitis can turn into something dangerous like meningitis or osteomyelitis (infection of a bone in your face). That being said, if you are concerned about your symptoms or not improving with the initial therapies your doctor recommended, please contact your doctor.

The Bottom Line

Sinusitis is a common medical ailment that causes headache and/or facial pain. The majority of cases are caused by viruses and will improve with time.

Your doctor will  consider many things when determining whether or not you need antibiotics like

  • the duration of your illness
  • the severity of your illness
  • symptoms prior to your sinus pain (like a previous "cold" that improved and then got worse).

A sinus infection can be confused with a migraine so speak with your doctor if you are having persistent "sinus headaches" that are not improving with basic therapies.


Chow AW, Benninger MS, Brook I, Brozek JL, Goldstein EJC, Hicks LA et al. IDSA Clinical Practice Guideline for Acute Bacterial Rhinosinusitis. in Children and Adults. Clin Infect Dis. 2012 Apr;54(8):e72-e112

Gwaltney JM, Wiesinger BA, Patrie JT. Acute community-acquired bacterial sinusitis: the value of antimicrobial treatment and the natural history. Clin Infect Dis 2004;38:227-33.

Pleis JR, Lucas JW, Ward BW. Summary health statistics for U.S. adults: National Health Interview Survey, 2012. Vital Health Stat 10 2009:1-157.

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