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Sinusitis: Patients
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Sinusitis is one of the most common diseases in the United States. According to the National Institute of Allergies and Infectious Diseases (NIAID), it affects an estimate 37 million Americans each year. However, a 2004 report in the Archives of Otolaryngology - Head and Neck Surgery suggests that sinusitis may not be as common as previously reported. The researchers found that accounts that rely solely on patient self-reporting may be exaggerated.
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Sinusitis is usually due to an infection, although swelling from allergies can mimic the symptoms of pressure, pain, and congestion, and allergies can set the stage for a bacterial infection. Bacteria are the most common cause of sinus infection. Streptococcus pneumoniae causes about 33 percent of all cases, while Haemophilus influenzae causes about 25 percent of all cases. Sinusitis in children may be caused by Moraxella catarrhalis (20%). In people with weakened immune systems (including patients with diabetes, acquired immunodeficiency syndrome or AIDS, and patients who are taking medications that lower their immune resistance, such as cancer and transplant patients), sinusitis may be caused by fungi such as Aspergillus, Candida, or Mucorales.
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Sinusitis is almost always due to an infection, although swelling from allergies can mimic the symptoms of pressure, pain, and congestion; allergies alsocan set the stage for a bacterial infection. Bacteria are the most common cause of sinus infection. People with weakened immune systems (including patients with AIDS) or patients who are taking medications which lower their immuneresistance may develop sinusitis caused by fungi.
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Many patients with sinusitis often complain of headache, and this symptom is considered one of the minor criteria for diagnosis of the disease. The sensation of pain and the generation of headache from an infection or even nasal congestion... is poorly understood. Theories originally postulated by Hans Stammberger supported the idea of contact headaches which may result from inflammation of the nose secondarily resulting in the generation of a headache or migraine. There are many sinus experts who do not feel that the term "sinus headache" has been appropriately used. This is supported by research[3][4][5] which indicates that pain or pressure felt by patients which they attribute to sinus disease, may indeed be a sign of a migraine headache or its variant. This confusion occurs in part because migraine involves activation of the trigeminal nerves which innervate both the sinus region but also the meninges which surround the brain.
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A doctor must be immediately consulted if any of the symptoms of sinusitis appear or are recognized by the person. There are rare instances of infections arising due to sinusitis spreading out to the facial areas around the eyes to form an orbital abscess or even spreading into the bone surrounding the sinuses-a condition known as osteomyelitis. There are ... extremely rare instances of sinusitis infection spreading into the brain of the affected individual to result in the formation of an abscess in the brain. The doctor is consulted to preclude the occurrence of any of these complications in a patient suffering from sinusitis-especially individuals who are suffering from a case of sinusitis for the first time.
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Trimethoprim-sulfamethoxazole (Bactrim, Cotrim, Septra) is another first-line antibiotic for sinusitis. It is less expensive than amoxicillin and particularly useful for patients with mild sinusitis who are allergic to penicillin. It is no longer effective... against certain streptococcal strains. It should not be used in patients whose infections occurred after dental work or in patients allergic to sulfa drugs. Allergic reactions can be very serious.
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