Sinus Infections That Don't Quit: When You Should Worry - Health Essentials

Having a sinus infection is both annoying and uncomfortable, especially when you can't seem to kick it. But what you may not realize is that an untreated sinus infection can actually turn into a serious problem. It's rare, but it can happen.

Otolaryngologist Raj Sindwani, MD, tells us what we need to know about sinus infections, including how long they typically take to clear up and what can happen if one sticks around too long.

What can happen if you don't treat a sinus infection?

In rare cases, untreated sinus infections, aka sinusitis, can impact your eyes and even your brain. Before we delve deeper into how that can happen, let's start with some of the basics.

Did you know that not all sinus infections are the same? They can be either viral or bacterial. The term "sinusitis" just means that there's irritation in your sinuses (which make up the lining around the air spaces between bones that surround your nose).

Whichever kind of infection you have, it probably all feels the same to you — stuffiness, sinus pressure, runny nose, headaches … you've been there, right? Symptoms of the different strains are so similar that healthcare providers typically recommend waiting seven to 10 days before seeking treatment.

"Viral infections, or the common cold, usually work themselves out in a week or two with nothing more than liquids, rest and supportive care like acetaminophen or ibuprofen," Dr. Sindwani says. "But if you don't get better, we start thinking there's a bacterial component."

And that's when things can get complicated.

The good news? Severe complications are rare

First, Dr. Singh emphasizes that it's very unlikely to experience severe complications from a sinus infection.

"In most cases, the bacterial infection goes away, especially if you don't have underlying medical problems," he says.

But serious cases are immediately treated with intravenous (IV) antibiotics. People are usually admitted to the hospital for a CT scan to see if fluid needs to be drained. "Before antibiotics, people would die from sinusitis," Dr. Sindwani shares, so it's important to monitor your symptoms.

Here are some of the rare but possible risks of an untreated sinus infection.

An infection of your eye socket

If left untreated, a sinus infection can spread to other parts of your body — like your eyes, which are very close to your sinuses. In rare cases, this can lead to orbital cellulitis, an infection of the skin, fat and muscles around your eyes.

Orbital cellulitis can typically be treated with antibiotics, but if it's not, it can cause eye issues like:

• Redness.
• Swelling.
• Bulging eyes.
• Reduced vision and even blindness.

A tear duct infection

Dacryocystitis is an infection of the tear ducts that can happen when (you guessed it) your bacterial sinus infection travels toward your eyes. Symptoms include eye pain, eye swelling and a pus-filled abscess or sore on the inner corner of your eyelid. It, too, can be treated with antibiotics but can cause vision problems if left untreated.

Brain infections

Your sinuses also offer a clean path to your brain. Rarely, an untreated sinus infection can spread and lead to conditions like meningitis, an infection of the membranes around the brain, or a buildup of pus called a brain abscess. Both conditions can be life-threatening but are often treatable with quick care.

A blood clot in your sinus

Cavernous sinus thrombosis is a rare blood clot that can form in response to an infection in your face or head. It can be fatal if left untreated, but that's now extremely uncommon thanks, again, to the modern-day wonder of antibiotics.

What to do if your sinus infection won't go away

In the early stages of a sinus infection, the only way to know whether you're dealing with a viral or bacterial infection is to swab inside the nose and grow a culture. So oftentimes, the best thing to do is just wait it out.

"Sinusitis often goes away by itself," Dr. Sindwani says, "but if it hangs on, you want to see your doctor."

Pay attention to the length of your sinus infection and whether it seems to be getting worse. If you can't shake it within seven to 10 days, make an appointment with a healthcare provider. And seek treatment immediately if you start experiencing worrisome symptoms like:

• Decreased vision.
• Double vision.
• Eye swelling.
• Light sensitivity.
• Severe headaches.
• Severe neck pain or stiffness.

"If you're dealing with a bacterial infection, that's when we may pull the trigger on an antibiotic," Dr. Sindwani says.

Antibiotics can help ward off rare but dangerous complications, but your provider will want to be careful only to prescribe them if you really need them. Antibiotics can cause unwanted side effects and lead to antibiotic resistance, which can make future infections harder to treat.

Chronic sinus infections — those that last longer than 12 weeks — can also be the result of other health issues like asthma, allergies and even a deviated septum. These aren't treated with antibiotics, but by figuring out and dealing with the underlying cause.

An acute sinus infection doesn't always turn into a chronic one. But keeping an eye on your symptoms and your timeline can help you avoid any serious complications and get back to breathing easy ASAP.

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