What Causes Paediatric Sinusitis?

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Sinusitis (rhino sinusitis) can affect children differently than adults. In children, it can cause a cough, bad breath, crankiness, low energy, and swelling around the eyes. Additionally, they might have a thick yellow-green nasal or post-nasal drip. Most of the time, children are diagnosed with viral sinusitis (or a viral upper respiratory infection) which can be treated by addressing the symptoms. However, in severe cases of bacterial sinusitis, antibiotics may be considered. If medical therapy fails, surgery can be used as a safe and effective method to treat sinus disease in children.

It's important to note that a child's sinuses are not fully developed until late in their teenage years. Although small, the maxillary (behind the cheek) and ethmoid (between the eyes) sinuses are present at birth. Like sinusitis in adults, diagnosing paediatric sinusitis can be difficult because the symptoms may be caused by other problems such as allergies or a viral illness.


What Are the Symptoms of Paediatric Sinusitis?

Possible symptoms of a sinus infection in your child include the following:

  • A cold that lasts more than 10 to 14 days.
  • Low to high-grade fever.
  • Thick yellow-green nasal discharge for at least three consecutive days.
  • Post-nasal drip, which may be accompanied by a sore throat, cough, bad breath, nausea, and/or vomiting.
  • Headache, usually in children aged six or older.
  • Irritability or fatigue.
  • Swelling around the eyes.


What Causes Paediatric Sinusitis

Young children are more susceptible to infections of the nose, sinus, and ears, especially during the first few years of their life. Sinusitis is usually caused by viruses, allergies, or bacteria. If your child has been sick for less than 10 days and the condition is not worsening, it is likely that they have acute viral sinusitis. However, if the symptoms persist for more than 10 days without any improvement or if your child's condition gets worse within 10 days of improving, it is likely that they have acute bacterial sinusitis. Chronic sinusitis lasts for 12 weeks or more and is usually caused by prolonged inflammation, rather than a long infection. Infection can be a part of chronic sinusitis, especially when it worsens from time to time.


What Are the Treatment Options?

If you take your child to an ear, nose, and throat (ENT) specialist, or otolaryngologist, they will examine your child's ears, nose, and throat to diagnose any problems. The doctor will also look for factors that can make your child more vulnerable to sinus infections, like allergies, structural changes, or immune system problems. During the appointment, the doctor may use special instruments to look into the nose. However, imaging scans like X-rays should not be done for acute sinusitis unless there are complications. This is because radiation safety concerns may limit imaging scans, especially in children younger than six years old.



What Is The Difference Between Acute Sinusitis and Chronic Sinusitis?

Understanding the differences between acute and chronic sinusitis is crucial for effectively managing these conditions. Here, we delve into the key distinctions and appropriate treatments for each.


Acute Sinusitis

If your child has bacterial sinusitis, they usually respond well to antibiotic therapy. In addition to antibiotics, your doctor may prescribe nasal steroid sprays or nasal saline drops or sprays for temporary relief of nasal congestion. It's important to note that decongestants and antihistamines sold over-the-counter are usually ineffective against viral upper respiratory infections in children and should not be given to children younger than two years old. If your child is diagnosed with acute bacterial sinusitis, symptoms should start improving within the first few days of antibiotic treatment. However, it's essential to complete the full course of antibiotics even if your child feels better. If your child has allergies or other conditions that worsen the sinus infection, your doctor may prescribe additional medication to treat them.


Chronic Sinusitis

If your child experiences two or more symptoms of sinusitis for at least 12 weeks and shows signs of sinus pressure, they may be suffering from chronic sinusitis. In case your child has chronic sinusitis or more than four to six episodes of acute sinusitis every year, it is recommended to see an ENT specialist who can suggest appropriate medical or surgical treatment. Surgery may be considered for a small percentage of children who continue to experience severe or persistent sinusitis symptoms despite medical therapy. In children under 13 years of age, the doctor may suggest the removal of adenoid tissue from behind the nose as a part of the treatment for sinusitis. Although the adenoid tissue does not directly obstruct the sinuses, adenoiditis (infection of the back of the nose that can cause blockage) can cause several symptoms similar to sinusitis, such as runny nose, stuffy nose, post-nasal drip, bad breath, cough, and headache.


When To See a Doctor?

If you experience repeated sinusitis, and the condition doesn't get better with treatment, it's advisable to schedule an appointment with your health care provider. Additionally, if you have sinusitis symptoms that last more than 10 days, seeing a health care professional is highly recommended. You should seek medical attention immediately if you have any of the following symptoms, as they could indicate a serious infection: fever, swelling or redness around the eyes, bad headache, forehead swelling, confusion, double vision or other vision changes, and stiff neck.

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