sinus infection specialist tests overview

Overview

A sinus infection, also called sinusitis, is when the sinuses (the air-filled spaces in your skull around your nose, cheeks, and eyes) become swollen and inflamed. This often happens after a cold or allergies and can cause pain, congestion, and pressure. Specialist tests help find the cause, especially when symptoms persist or are severe.

Yes, sinus infections are very common. Many adults have at least one episode each year, especially during cold and flu season.

Sinus infections can affect anyone, but they are more common in adults, people with allergies, asthma, nasal polyps, or a weakened immune system, and those who smoke or are often around smoke.

Symptoms

Common symptoms

• Pain, pressure, or fullness in your face (especially around your nose, eyes, or forehead)
• Nasal congestion or stuffiness, making it hard to breathe through your nose
• Thick, yellow or green discharge from your nose or down the back of your throat (postnasal drip)
• Reduced sense of smell or taste
• Headache, especially when bending forward
• Fever, cough, bad breath, or tiredness

Symptoms in children

• Cold-like symptoms that last more than 10 days without improving
• Bad breath or cough that doesn't go away
• Irritability, fussiness, or trouble sleeping
• Swelling around the eyes, especially in the morning

Symptoms in older adults

• Symptoms may be less typical, such as a lingering cough or general fatigue
• Fever is less common than in younger people
• Confusion or dizziness may occur if the infection is severe

Causes

Main causes

• Viral infections, like the common cold or flu — the most common cause
• Bacterial infections — can happen when sinuses are blocked and fluid builds up
• Fungal infections — rare, mostly in people with weakened immune systems

Risk factors

• Allergies (hay fever, dust, mould) that cause chronic nasal swelling
• Nasal polyps (small growths in the nose) or a deviated septum
• Asthma or other conditions that affect the breathing passages
• Smoking or exposure to second-hand smoke
• Frequent colds or a weakened immune system (e.g., from diabetes, HIV, or chemotherapy)

When to see a doctor

See a doctor urgently if:

• Symptoms lasting more than 10 days without improvement
• Severe facial pain or headache that doesn't get better with simple pain relief
• A high fever (over 39°C / 102°F) that lasts more than a few days
• Symptoms that get worse after starting to get better (double sickening)

Book a routine appointment if:

• You have sinus infections that come back several times a year
• Symptoms are affecting your daily life, work, or sleep
• You have tried self-care for two weeks and still feel unwell

Diagnosis

Your doctor will start by asking about your symptoms and examining your nose with a light. If they suspect a deeper problem, or if your symptoms keep coming back, they may refer you to an ear, nose, and throat (ENT) specialist for more detailed tests.

Tests that may be done

• Nasal endoscopy: A thin, flexible tube with a small camera is gently placed into your nose so the specialist can see inside your sinuses and check for blockages, polyps, or swelling.
• CT scan: A special X-ray that creates detailed pictures of your sinuses. It shows where the inflammation or blockage is and helps plan treatment.
• Allergy testing: Skin or blood tests to see if allergies (like dust mites, pollen, or pet dander) are contributing to your sinus problems.
• Sinus culture: A swab of mucus from your nose is sent to a lab to find out if bacteria or fungi are causing the infection and which antibiotics might work.
• Blood tests: These can check for signs of infection, inflammation, or immune system problems that might make you more prone to sinus infections.

What to expect at your appointment

The specialist will first talk with you about your symptoms and medical history. Then they may look inside your nose with an endoscope (it feels a bit strange but is not painful). If more information is needed, they might order a CT scan or allergy tests. You will get clear instructions before any test, and most tests are done in the clinic as an outpatient.

Treatment

Treatment for sinus infections depends on what is causing them. Most are caused by viruses and get better without antibiotics. If tests show a bacterial or fungal infection, or if allergies are involved, your doctor will suggest treatments that target the specific cause. The goal is to reduce swelling, help mucus drain, and ease your symptoms.

Self-care at home

• Use saline (salt water) nasal rinses or sprays to keep your nose moist and flush out mucus.
• Place a warm, damp cloth over your face to help relieve pain and pressure.
• Inhale steam from a bowl of hot water or a warm shower to loosen congestion.
• Drink plenty of fluids (water, herbal tea) to thin the mucus.
• Rest and use a humidifier in your room, especially at night.
• Avoid smoking and second-hand smoke.

Medical treatments

If tests show a bacterial infection, your doctor may prescribe a course of antibiotics. For allergies, antihistamines, nasal steroid sprays, or allergy shots might be recommended. If the sinus infection is due to a fungus, antifungal medicines may be used. For severe swelling, a short course of oral steroids can help reduce inflammation. Always take any prescribed medicines exactly as directed and finish the full course if it is an antibiotic.

When is surgery considered?

Surgery is only considered when medicines and self-care have not helped, especially for chronic sinusitis. The most common procedure is functional endoscopic sinus surgery (FESS), where the surgeon uses a thin telescope to open blocked sinus passages and remove polyps or other blockages. This can improve drainage and reduce future infections.

Living with this condition

Living with chronic sinus symptoms can be frustrating, but many people find relief by sticking to a routine of nasal care. Using saline rinses daily, avoiding triggers like smoke or strong perfumes, and keeping your immune system strong can help reduce flare-ups.

Lifestyle tips

• Avoid cigarette smoke and polluted air.
• Use air purifiers or filters in your home to reduce allergens.
• Keep your home well-ventilated and dust-free.
• Wash your hands often to avoid catching colds and flu.
• Manage allergies with help from your doctor.

Diet and exercise

Eat a balanced diet rich in fruits, vegetables, and whole grains to support your immune system. Drinking plenty of water helps keep mucus thin. Gentle exercise, like walking or yoga, can boost circulation and help clear your head, but if you feel very congested, it's okay to rest.

Mental health and emotional wellbeing

Dealing with ongoing sinus pain, poor sleep, and a reduced sense of smell can be draining. Some people feel irritable, depressed, or anxious. It's important to talk to your doctor if these feelings become overwhelming.

Prevention

You can lower your chances of getting a sinus infection by avoiding colds and flu, managing allergies, and not smoking. Using a humidifier in dry rooms and washing your hands often also help. But some causes, like a deviated septum or nasal polyps, cannot always be prevented.

Vaccines

Getting the annual flu vaccine can help prevent flu-related sinus infections. Your doctor may also recommend the pneumococcal vaccine if you are at higher risk, as it protects against some bacterial causes of sinusitis. Ask your GP if you need it.

Screening programmes

There is no routine screening for sinus infections. If you have allergies or frequent colds, your doctor may suggest allergy testing to find and avoid triggers.

Complications

If left untreated

• Infection can spread to the eye socket, causing swelling, vision changes, or even blindness (rare but serious).
• Infection can spread to the bones of the face (osteomyelitis) or to the brain (meningitis or brain abscess).
• Chronic sinusitis can lead to nasal polyps, loss of smell, and persistent pain that affects quality of life.

Long-term outlook

The outlook for most people with sinus infections is excellent. With proper diagnosis and treatment, even chronic sinusitis can be managed well. Most people return to their normal activities without long-term problems. If you need specialist tests, they will help find the right treatment for you, so you can feel better sooner.

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