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Viral vs. bacterial sinus infections: How to tell the difference


Viral vs. bacterial sinus infections: How to tell the difference

This time of year, physicians in our region see a steady stream of patients with sinus-related concerns.
Often, the problem is seasonal allergies that can be treated with over-the-counter antihistamines. For others, however, the problem is a sinus infection.
“Sometimes, symptoms overlap so it can be hard to tell,” says Dr. Julia Brogdon, chief resident at the Tidelands Health MUSC Family Medicine Residency Program.

How to tell the difference

If your sinus pain comes with a fever, odds are high you’re dealing with an infection rather than allergies. The type of infection – viral or bacterial – will determine the course of treatment.
“It’s common for people to assume their sinus infections is bacterial,” Dr. Brogdon says. “But bacterial infections are much less common.”

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It’s more likely your infection is viral in nature and will clear up on its own after a few days. Over-the-counter medications, including sprays and decongestants, can help address symptoms in the meantime, but follow instructions for using the medications carefully. Also be sure to drink plenty of fluids and rest.
One thing that won’t help a viral sinus infection, Dr. Brogdon says, is a prescription for antibiotics. Antibiotics are often the first thing patients request to address a sinus infection, but antibiotics will not help infections caused by viruses. Taking antibiotics unnecessarily can make future infections harder to treat by raising the risk of antibiotic resistance.

Bacterial or viral?

So how do you know if your sinus infection is viral or bacterial?
First, ignore what’s coming out of your sinuses, Dr. Brogdon says. The color and consistency of discharge doesn’t reliably indicate the cause of your infection.
A better measure is to look at the severity and duration of your symptoms. Bacterial infections often present with more severe symptoms that don’t improve with time. If your symptoms aren’t improving after one week or you have a persistent fever greater than 100.4 degrees, it’s a good idea to seek medical care. In case of emergency, seek immediate medical care.
“If you’ve got a bacterial infection, it will not get better on its own – you’re going to need an antibiotic,” Dr. Brogdon says.

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