01/10/2026
Bacterial Sinusitis: Causes, Signs & Management
Bacterial sinusitis is an infection of the sinuses, usually developing after a viral upper-respiratory infection. Most sinus infections are viral, so antibiotics are only useful when the symptom pattern suggests a bacterial cause.
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🟣 Facial Pain or Pressure
➟ Pain or pressure may occur over the cheeks, forehead, or around the eyes
➟ It may feel worse when bending forward
➟ Tooth pain, especially in the upper teeth, can also occur
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🟣 Nasal Congestion
➟ The nose may feel blocked or very stuffy
➟ Swelling inside the nasal passages can make breathing through the nose difficult
➟ Congestion may affect one or both sides
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🟣 Thick Nasal Discharge
➟ Nasal mucus may become thick, yellow, or green
➟ Discoloured mucus alone does not prove a bacterial infection, because viral infections can cause the same change
➟ Persistent discharge together with the typical timing pattern is more suggestive
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🟣 Reduced Sense of Smell
➟ Inflammation and blockage can reduce the ability to smell
➟ Taste may also seem weaker because much of flavour depends on smell
➟ Smell usually improves as the infection settles
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🟣 Fever
➟ Fever may occur, particularly in more severe bacterial infection
➟ A high fever with marked facial pain or purulent nasal discharge is more concerning for bacterial sinusitis
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🟣 Typical Bacterial Pattern
➟ Symptoms lasting more than 10 days without improvement can suggest bacterial sinusitis
➟ Another pattern is severe symptoms from the start, such as high fever with facial pain and purulent discharge for several days
➟ “Double worsening” is also important — symptoms begin to improve and then become significantly worse again
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🟣 Common Cause
➟ Bacterial sinusitis often develops after a viral cold or upper-respiratory infection
➟ Viral inflammation blocks normal sinus drainage, allowing bacteria to grow in some cases
➟ Allergy and structural nasal problems can also increase susceptibility
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🟣 Associated Symptoms
➟ Headache or facial heaviness
➟ Upper tooth pain
➟ Bad breath
➟ Cough, often worse at night
➟ Ear pressure or fullness may also occur
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🟣 Management
➟ Saline nasal rinses can help clear mucus and improve drainage
➟ Pain or fever medicines such as paracetamol/acetaminophen or ibuprofen may help when appropriate
➟ Intranasal corticosteroid sprays may be useful, especially when allergy or significant nasal inflammation is present
➟ Drink enough fluids and get adequate rest
➟ A humidifier or moist air may improve comfort for some people
➟ Antibiotics may be prescribed when the clinical pattern strongly suggests bacterial infection or symptoms are severe
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🟣 Antibiotics Are Not Always Needed
➟ Most acute sinus infections are viral and improve without antibiotics
➟ Unnecessary antibiotics can cause side effects and contribute to antibiotic resistance
➟ If antibiotics are prescribed, take them exactly as directed and complete the course unless your clinician tells you otherwise
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🟣 Seek Medical Advice If
➟ Symptoms last longer than about 10 days without improving
➟ Symptoms improve and then suddenly worsen again
➟ Severe facial pain or high fever develops
➟ Sinus infections keep recurring
➟ Symptoms are not improving despite appropriate treatment
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🟣 Seek Urgent Medical Care If
➟ There is swelling or redness around the eye
➟ Vision becomes blurred, double, or reduced
➟ Severe headache, confusion, stiff neck, or marked drowsiness develops
➟ Facial swelling becomes severe or rapidly worsens
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Medical disclaimer: This information is for general educational purposes only and does not replace professional medical advice, diagnosis, or treatment. Persistent, severe, recurrent, or complicated sinus symptoms should be assessed by a qualified healthcare professional.
