sinus infection with fever

Overview

A sinus infection (also called sinusitis) is swelling of the lining of your sinuses, which are small air-filled spaces behind your forehead, cheeks, and eyes. When you have a fever along with it, it often means your body is fighting an infection, usually a virus, but sometimes bacteria.

Very common. Most adults have at least one sinus infection in their lifetime.

It can affect people of all ages, but it is more common in people with allergies, asthma, a weakened immune system, or structural issues in the nose.

Symptoms

Common symptoms

• Runny or blocked nose
• Thick yellow or green mucus
• Pain or pressure in your face, cheeks, or forehead
• Fever (temperature above 100.4°F or 38°C)
• Headache
• Cough or sore throat
• Bad breath
• Fatigue

Symptoms in children

• Fussiness or irritability
• Trouble feeding or eating
• Breathing through the mouth
• Cough that gets worse at night

Symptoms in older adults

• Less obvious fever, or no fever at all
• Confusion or dizziness
• Cough that does not go away
• Milder facial pain that may be overlooked

Causes

Main causes

• Viral infections, such as the common cold
• Bacterial infections, which can happen when viruses or inflammation block the sinuses
• Allergies that cause the inside of the nose to swell
• Nasal polyps (small growths in the nose) or a deviated septum (a shifted bone inside the nose)

Risk factors

• Recent cold or flu
• Allergic rhinitis (hay fever)
• Asthma
• Smoking or exposure to secondhand smoke
• Weakened immune system
• Nasal structural problems
• Dental infection

When to see a doctor

See a doctor urgently if:

• High fever (over 103°F or 39.4°C), or fever lasting more than 3 days
• Severe headache or facial pain
• Swelling around the eyes or forehead
• Stiff neck
• Confusion
• Shortness of breath

Book a routine appointment if:

• Symptoms lasting more than 10 days without improving
• Symptoms that get worse after starting to get better
• Fever lasting more than 3 days (even if low-grade)
• Several sinus infections within a year

Diagnosis

Your doctor will ask about your symptoms and examine your ears, nose, and throat. They may press gently on your face to check for tenderness.

Tests that may be done

• Usually no tests are needed
• If symptoms are severe or do not improve, your doctor may order a CT scan of your sinuses
• They may take a sample of mucus to check for bacteria (only in some cases)

What to expect at your appointment

Your doctor will likely recommend home care first, especially if they suspect a viral infection. If they suspect a bacterial infection, they may consider prescribing antibiotics. They will explain what they found and give you a plan.

Treatment

Treatment depends on the cause. Since most sinus infections are viral, antibiotics will not help. The goal is to relieve symptoms and let your body recover. If bacteria are causing the infection, a short course of antibiotics may be prescribed.

Self-care at home

• Rest and get enough sleep
• Drink plenty of fluids (water, clear soup, warm tea)
• Apply a warm, damp cloth to your face to ease pain
• Inhale steam from a warm shower or a bowl of hot water to help open your nose
• Use a saline (saltwater) nasal spray or rinse to keep your nasal passages moist
• Avoid smoke and strong fumes
• Prop your head up with extra pillows while sleeping

Medical treatments

If your doctor thinks you have a bacterial infection, they may prescribe antibiotics. They might also suggest nasal corticosteroid sprays to reduce swelling, or decongestant nasal sprays for a short time (no more than a few days). Never use decongestant sprays for longer than the label says. Always follow your doctor's advice. You can also ask your pharmacist about over-the-counter pain relievers to help with headache or facial pain.

When is surgery considered?

Surgery is not common. It is only considered for serious or repeated sinus infections that do not improve with other treatments, or if you have nasal polyps or a deviated septum that blocks the sinuses.

Living with this condition

While you recover, plan to take it easy. You may need to stay home from work or school if you have a fever. Use the self-care tips above and keep a tissue box handy. Your sense of smell may be reduced for a while, but it usually returns as the infection clears.

Lifestyle tips

• Stop smoking and avoid secondhand smoke
• Use a humidifier in your home to keep the air moist
• Avoid known allergens that trigger your symptoms
• Wash your hands often to avoid spreading the infection

Diet and exercise

Drink plenty of fluids like water, juice, and warm soup. A balanced diet supports your immune system. Light exercise like walking is fine if you feel up to it, but avoid heavy workouts until your fever is gone.

Mental health and emotional wellbeing

Being sick with a fever and facial pain can make you feel frustrated or low. It is normal to feel this way. Give yourself time to rest and heal. If you feel your mood is significantly affected, talk to your doctor.

Prevention

You can lower your risk by washing your hands often, avoiding close contact with people who are sick, and managing allergies well. If you smoke, seek help to quit.

Vaccines

Getting vaccinated against influenza and COVID-19 can reduce your chances of getting a viral infection that can lead to sinusitis. Ask your doctor what vaccines are right for you.

Screening programmes

There is no routine screening for sinus infections. If you have allergies, treating them can help prevent sinus episodes.

Complications

If left untreated

• Spread of infection to the eye or brain (rare but serious)
• Bone infection (osteomyelitis)
• Meningitis (infection of the lining around the brain)
• Chronic sinusitis, lasting more than 12 weeks
• Loss of smell (usually temporary)

Long-term outlook

With proper care, most sinus infections with fever improve within 7 to 14 days. Even bacterial sinusitis is very treatable. Serious complications are rare, especially if you see a doctor when needed. Your body is strong, and this illness will pass.

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