Acute Bacterial Rhinosinusitis

What is acute bacterial rhinosinusitis?

Acute bacterial rhinosinusitis (ABRS) is a bacterial sinus infection. It commonly begins as a virus, often as a common cold. Viruses usually last 7 to 10 days and do not need treatment. When the virus does not get better on its own, you may have ABRS. This means that bacteria have begun to grow inside your sinuses.

What are the signs and symptoms of acute bacterial rhinosinusitis?

Your signs and symptoms may be worse when you lie on your back or try to sleep. You may have any of the following:

  • Stuffy nose and reduced sense of smell

  • Runny nose with thick yellow or green mucus

  • Pressure or pain on your face or a headache

  • Pain in your teeth or bad breath

  • Ear pain or pressure

  • Fever or cough

  • Tiredness

How is acute bacterial rhinosinusitis diagnosed?

Your caregiver will feel your sinuses and look in your eyes, nose, mouth, and ears. He will ask you about your symptoms and how long you have had them. Tell him if your symptoms have gotten better or worse since they began. You may have ABRS if your symptoms have gotten worse after 5 to 7 days or lasted longer than 10 days. You may need the following tests:

  • A sample of the mucus from your nose may be tested to find what germ is causing your infection.

  • An X-ray or a CT scan may be done to check for problems or abnormal areas in your sinuses.

How is acute bacterial rhinosinusitis treated?

  • Antibiotics fight or prevent a bacterial infection.

  • Decongestants help reduce swelling and drain mucus in the nose and sinuses. They may help you breathe normally.

  • Antihistamines help dry mucus in the nose and relieve sneezing.

  • NSAIDs help decrease swelling and pain or fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If you take blood thinner medicine, always ask your healthcare provider if NSAIDs are safe for you. Always read the medicine label and follow directions.

  • Acetaminophen decreases pain and fever. It is available without a doctor's order. Ask how much to take and how often to take it. Follow directions. Acetaminophen can cause liver damage if not taken correctly.

How can I manage my symptoms?

  • Rinse your sinuses. Use a sinus rinse device to rinse your nasal passages with a saline (salt water) solution. This will help thin the mucus in your nose and rinse away pollen and dirt. It will also help reduce swelling so you can breathe normally. Ask your caregiver how often to do this.

  • Breathe in steam. Heat a bowl of water until you see steam. Lean over the bowl and make a tent over your head with a large towel. Breathe deeply for about 20 minutes. Be careful not to get too close to the steam or burn yourself. Do this 3 times a day. You can also breathe deeply when you take a hot shower.

  • Sleep with your head elevated. Place an extra pillow under your head before you go to sleep to help your sinuses drain.

  • Drink liquids as directed. Ask your caregiver how much liquid to drink each day and which liquids are best for you. Liquids will thin the mucus in your nose and help it drain. Avoid drinks that contain alcohol or caffeine.

  • Do not smoke and avoid secondhand smoke. If you smoke, it is never too late to quit. Smoking will make your symptoms worse. Ask for information if you need help quitting.

When should I contact my caregiver?

  • Your symptoms are worse or do not improve after 3 days of treatment.

  • You have questions or concerns about your condition or care.

When should I seek immediate care or call 911?

  • Your eye and eyelid are red, swollen, and painful.

  • You cannot open your eye.

  • You have double vision or you cannot see.

  • Your eyeball bulges out or you cannot move your eye.

  • You are more sleepy than normal, or you notice changes in your ability to think, move, or talk.

  • You have a stiff neck, a fever, or a bad headache.

  • You have swelling of your forehead or scalp.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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