Sinusitis in Children

What is sinusitis in children?

Sinusitis is an infection of the sinuses. These infections often happen after a cold or with allergies. There are 3 types of sinusitis:

• Short-term (acute). Symptoms of this type of infection last less than 12 weeks and get better with the correct treatment.

• Long-term (chronic). These symptoms last longer than 12 weeks.

• Recurrent. This means the infection comes back again and again. It means 3 or more episodes of acute sinusitis in a year.

The sinuses are air-filled spaces (cavities) near the nose. They are lined with mucous membranes. There are 4 different sinuses:

• Ethmoid sinus. Located around the bridge of the nose. This sinus is present at birth and continues to grow.

• Maxillary sinus. Located around the cheeks. This sinus is also present at birth and continues to grow.

• Frontal sinus. Located in the area of the forehead. This sinus does not develop until around age 7.

• Sphenoid sinus. Located deep behind the nose. This sinus does not develop until the teen years.

What causes sinusitis in a child?

When the sinuses are blocked with discharge, bacteria may start to grow. This leads to a sinus infection or sinusitis.

The most common bacteria that cause acute sinusitis include:

• Streptococcus pneumonia

• Haemophilus influenzae

• Moraxella catarrhalis 

What are the symptoms of sinusitis in a child?

These are the most common symptoms of sinusitis:

• Stuffy nose

• Thick, colored drainage in the nose

• Drainage down the back of the throat (postnasal drip)

• Headache

• Cough

• Pain or soreness over sinuses

• Fever

• Loss of smell

The symptoms of sinusitis can seem like other health conditions. Make sure your child sees their healthcare provider for a diagnosis.

Which children are at risk for sinusitis?

A sinus infection sometimes happens after an upper respiratory infection or common cold. The cold causes swelling that can block the opening of the sinuses. This can cause a sinus infection. Allergies can also lead to sinusitis because of swelling and increased mucus. Other possible conditions that can lead to sinusitis include:

• Abnormal shape of the nose

• Infection from a tooth

• Nose injury

• Foreign object in the nose

• Birth defect with abnormality of the roof of the mouth (cleft palate)

• Problem with stomach acids (gastroesophageal reflux disease, or GERD)

• Cystic fibrosis and immunodeficiency syndromes

• Large adenoids (tissue behind the nose)

Immune problems or antibody deficiencies are risks for chronic sinus conditions.

How is sinusitis diagnosed in a child?

The healthcare provider will ask about your child’s symptoms and health history. They will give your child a physical exam. Your child may also have tests, such as:

• Sinus X-rays. An X-ray exam of the sinuses may help with the diagnosis.

• CT scan of the sinuses. A CT scan shows detailed images of any part of the body. They are more detailed than X-rays.

• Cultures from the sinuses. A swab of discharge from the nose may be taken. The sample is checked for bacteria or other germs.

How is sinusitis treated in a child?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.

What are possible complications of sinusitis in a child?

In very rare cases, acute sinusitis can result in a brain infection.

What can I do to prevent sinusitis in my child?

There are things that can help your child prevent sinusitis. They include:

• Support a healthy lifestyle by providing a healthy diet, encouraging good fluid intake, and making time for physical exercise.

• Have your child use saline sprays, washes, or both. Use these often to keep the nose as moist as possible.

• Use a humidifier in dry indoor environments.

• Keep your child away from cigarette and cigar smoke. Don't allow smoking in your home or car.

• Keep your child away from things that cause allergy symptoms.

• Don't force water into the sinuses. For example, your child should not jump into water.

• Limit time in chlorinated pools. The chlorine can irritate the nose and sinuses.

• Teach your child when and how to wash their hands.

• Keep you and your child up-to-date on immunizations.

• Don't have close contact with people who have colds or other upper respiratory infections.

Key points about sinusitis in children

• Sinusitis is an infection of the sinuses.

• When discharge from the nose is blocked, bacteria may start to grow. This leads to a sinus infection or sinusitis.

• Acute sinusitis may get better on its own. But if it doesn’t, medicine can be prescribed.

• For chronic sinusitis, the healthcare provider may refer your child to an ear, nose, and throat doctor (ENT) for testing and treatment.

• To help prevent sinusitis, encourage a healthy lifestyle and have your child use saline sprays or washes to keep the nose moist. Use a humidifier in dry inside areas.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.

• Before your visit, write down questions you want answered.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.

• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.

• Ask if your child’s condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if your child does not take the medicine or have the test or procedure.

• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.