Sinusitis is an infection of the nose and sinus usually caused by virus or bacteria. In most healthy adults, viral infections of the nose and sinus will last about a week and include symptoms such as runny nose, congestion, stuffy nose, coughing and sometimes fevers (acute sinusitis). Rhinovirus, influenza and parainfluenza are the usual culprits, but some may go on to have bacterial infections that often require antibiotics.

Typically viral infections will pass with time and improve with over the counter medications as the body fights the virus and antibiotics are not needed.  If symptoms last longer than a week, the infection may be due to bacteria as the virus makes the mucus thick and blocks the sinus cavities from drainage, leading to bacterial growth. Common bacteria that lead to acute bacterial sinusitis are streptococcus, staphlyococcus,, H. influenzae, and Moraxella in kids. 

Allergies to things such as pollens and dust can make things worse. Some patients have anatomical problems with their sinus including a deviated nasal septum or enlarged turbinates or even polyps that may block the drainage pathways and lead to recurrent or persistent problems. Often patients will require a CT scan and nasal endoscopy to diagnose the problem. A nasal endoscopy is a small camera at the end of a lighted narrow rod that the surgeon uses to look into the nose and sometimes to visualize the sinus cavities. This procedure is quick and well tolerated especially when performed after a numbing spray is applied in the nose. Occasionally surgery or office procedures are recommended to get rid of chronic sinus infections as well as to improve breathing.