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Patient education: Sinusitis in children (The Basics)

Patient education: Sinusitis in children (The Basics)

What is sinusitis? — Sinusitis is a condition that can cause a stuffy nose, cough, pain in the face, and discharge (mucus) from the nose. The sinuses are hollow areas in the bones of the face (figure 1). They have a thin lining that normally makes a small amount of mucus. When this lining gets irritated or infected, it swells and makes extra mucus. This causes symptoms.

Sinusitis can happen when a child gets sick with a cold. The germs causing the cold can also infect the sinuses. Often, the child seems to be getting over the cold but then gets sinusitis and begins to feel sick again.

What are the symptoms of sinusitis? — Common symptoms of sinusitis in children include:

Cough

Stuffy or blocked nose

Discharge from the nose

Fever

Headache

Pain or swelling in the face

Sore throat

Bad breath

Most of the time, symptoms start to improve in 7 to 10 days.

Should my child see a doctor or nurse? — Take your child to the doctor or nurse if any of the following is true:

The child has had a stuffy, runny, or blocked nose for more than 10 days, and it is not getting better.

The child has fever higher than 100.4°F (38°C), has yellow or green discharge from the nose for 3 or 4 days in a row, and looks sick.

The child's symptoms get better at first but then get worse.

Sometimes, sinusitis can lead to serious problems. Take your child to the doctor or nurse right away (do not wait 10 days) if they have any of these symptoms:

Fever higher than 102.2°F (39°C)

Sudden and severe pain in the face and head

Trouble seeing, or seeing double

Trouble thinking clearly

Swelling or redness around 1 or both eyes

Trouble breathing

Stiff neck

Is there anything I can do to help my child feel better? — Yes. To relieve your child's symptoms, you can:

Give your child an over-the-counter pain reliever, such as acetaminophen (brand name: Tylenol) or ibuprofen (sample brand names: Advil, Motrin) to reduce the pain. But never give aspirin to any child younger than 18 years old. In children, aspirin can cause a life-threatening condition called Reye syndrome. When giving your child acetaminophen or other over-the-counter medicines, never give more than the recommended dose.

Rinse your child's nose and sinuses with salt water a few times a day – Ask the doctor or nurse about the best way to do this.

Make sure that your child drinks plenty of fluids – Staying hydrated might help thin the mucus and make it drain more easily.

Do not give your child cold or allergy medicines for sinusitis. Those medicines could make your child's symptoms worse. Plus, cold medicines are not safe for children younger than 6.

How is sinusitis treated? — Most of the time, sinusitis does not need to be treated with antibiotic medicines. This is because most sinusitis is caused by viruses, not bacteria, and antibiotics do not kill viruses. Many children get over sinus infections without antibiotics.

Some children with sinusitis do need treatment with antibiotics. If your child's symptoms have not improved after 10 days or if your child gets better and then gets worse again, ask the doctor if they need antibiotics. If your child gets antibiotics, make sure that they take them exactly as directed and finish the whole prescription.

What if my child does not get better with treatment? — If your child's symptoms do not start to get better after 3 days of treatment, talk with their doctor or nurse. Your child might need a different antibiotic. If that doesn't work, the doctor or nurse might order other tests, but that is not usually needed. Tests to figure out why a child still has symptoms can include:

CT scan or other imaging tests – Imaging tests create pictures of the inside of the nose and sinuses.

A test to look inside the sinuses – For this test, a doctor puts a thin tube with a camera on the end into the nose and up into the sinuses.

More on this topic

Patient education: Cough in children (The Basics)
Patient education: Giving your child over-the-counter medicines (The Basics)

Patient education: Acute sinusitis (sinus infection) (Beyond the Basics)
Patient education: The common cold in children (Beyond the Basics)

This topic retrieved from UpToDate on: Feb 02, 2024.
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