If you've been congested or had other symptoms for weeks, you may have a sinus infection.
April 12, 2013
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Signs of a sinus infection
A stuffy nose may seem like a winter staple. Still, if you’ve been congested and experiencing other uncomfortable symptoms for weeks, you could have a sinus infection.
These types of infections usually go away with time, but some severe and persistent cases require antibiotics.
Here are 10 signs you may need more than a few tissues to cure your "cold."
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You’ve got pain and pressure in your face
Sinuses (which are cavities behind the forehead, nasal bones, cheeks, and eyes) do have a purpose. One is to help warm, filter, and moisten the air that you breathe in.
Another is to make sure your head isn’t too heavy. Sinuses “open up space so that your head doesn’t weigh a ton,” explains Louis Papa, MD, an internist and professor of clinical medicine at the University of Rochester Medical Center in New York.
But if the tiny holes that connect the sinuses to your nasal passages become plugged, they can’t drain properly. The accumulation of mucus results in a feeling of heaviness in your face as well as pain from increased pressure on your nerves.
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You hurt when you move
Facial pain and pressure when you lean forward or move your head could also be a sign of a sinus infection. This is because the inflammation of the sinus membranes and mucus throws off the sense of balance you perceive in the head.
"When you lean forward, the inflamed mucus membrane and mucusand your now heavier headchange the way your brain interprets head position and weight and give the sensation of fullness in your face and the sensation of being 'off balance,' " Dr. Papa says. "The brain is used to a lighter and more symmetrical head without all the unequal swelling and mucus."
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Your head aches
That swelling and pressure in the face from stopped-up sinuses can morph into a headache.
The blockage in your sinuses and the inflammation cause you to automatically tighten the muscles around the forehead and the top of your headas when you have a typical tension headache.
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Your mucus is yellow or greenish
A colored dischargeas opposed to clear mucusfrom the nose or down the back of your throat is another sign you may have a sinus infection, although it’s not always an indication that you need treatment.
Discoloration is actually caused by white blood cells. In other words, it is a sign that the immune system is already fighting the infection. In fact, the yellow or green tinge can stick around for a few days or even weeks after the infection is over because immune cells are still draining. "It’s basically pus," Dr. Papa says.
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Your nose is stuffy
A clogged nose is the classic symptom of sinusitis (which is just another word for "inflamed sinuses").
"The infection by the virus or bacteria elicits an inflammatory response by the body," Dr. Papa says. Blood rushes to the nose, bringing inflammatory cells to fight the infection, and this increased blood flow causes the nose tissues to swell. Although a stuffy nose is also a prime symptom of a cold, one way to tell the difference is that symptoms usually last longer when it’s a sinus infection.
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You’ve got bad breath
Halitosisthat noxious, embarrassing smell emanating from your mouthis an unwanted by-product of the colored discharge that collects in your sinuses and nose and drips into the back of your throat.
The organisms that cause the infection produce volatile by-products that contribute to the smell. "Bad breath occurs because [breath] mixes with the odor from the infection," Dr. Papa says.
But Dr. Papa adds that sinus infections can affect your breath in other ways, too. The infection as well as medications like antibiotics used to treat the infection can dry out the mouth and contribute to bad breath.
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You cough up phlegm
A so-called "productive" cough often accompanies a sinus infection. Some people even mistake it for a cold or bronchitis. However, coughing from a sinus infection usually gets worse at night and in the morning, whereas coughing from bronchitis is more consistent throughout the day and night.
The night/morning hacking is a result of the sinuses draining down the back of your throat when you lie down, triggering the cough receptor in the back of the nasal pharynx, Dr. Papa explains.
"Anything that collects at the back of your nose is going to trigger a cough like that. It comes up in the morning because that’s when it all drains out," he says.
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You’ve got a fever
Simple congestion usually doesn’t result in a fever, but a sinus infection can. Your core body temperature rises because your body’s immune system is gearing up to fight off the infection. Sinus infection fevers are usually low grade, but they can be an indication that the infection has settled in for a longer stay.
"The body is trying to kill off the bacteria by raising the core body temperature," Dr. Papa says, adding that this usually suggests that something serious is going on, especially if you didn’t have the fever at the beginning of the infection or the fever got worse, and that you need to see a doctor.
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Your teeth hurt
Tooth pain related to a sinus infection isn’t actually tooth pain; it comes from all that pressure building up inside the head, merely giving the impression of a nasty old toothache.
Usually a sinus-related toothache is bilateral, meaning it occurs on both sides of the face. And when you push down on the tooth, it doesn’t send you shrieking in pain as a regular toothache would. "It’s referred pain, like arm pain in a heart attack," Dr. Papa explains.
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Your sense of smell or taste is "off"
Again, the same inflammation that interferes with your sinuses’ natural ability to drain can mess with your sense of smell and taste.
Air movement in the sinuses normally "helps volatile molecules to settle in and provide a signal to the brain to let you know what you’re tasting," Dr. Papa says.
So a sinus infection can dull your sense of taste, even though you’ll still be able to tell if something is salty or sweet, according to Dr. Papa. But finer nuances of tastelike the flavor of a fine wine or subtle soufflémight be lost on you until your sinuses become unplugged.
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When to call a doctor
Although they’re rare, untreated sinus infections can sometimes damage the sinuses and lead to chronic sinusitis, ear infections, vision loss, or even meningitis (if the bacteria attacks the membranes surrounding the brain and spinal cord).
If symptoms persist beyond 10 days, you have a fever, experience a headache that does not get better with over-the-counter pain relievers, or your discharge is discolored, you may need to see a doctor to get a course of antibiotics to stomp out the infection once and for all.
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