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An estimated 37 million people are afflicted with sinusitis, infection of the sinuses, and its related conditions each year.

But sinusitis can be hard to diagnose, especially in children – and sometimes it can even mimic other ailments.

Four-year-old Carsten, for example, was brought into the ER with a lump on his head.

He was hit while playing t-ball, and a week later still has headaches.

“ Carson looked very good on exam,” says Dr. Michael Mallory, of Children’s Healthcare of Atlanta. “His neurological exam was non-focal; he was actually happy and playful. He was still complaining of a headache and he had tenderness at the left side of the head.”

To see if Carsten’s skull might be fractured or if there is bleeding, the doctor orders a CAT scan.

According to the CT scan, the boy did not suffer a skull fracture. It did show, however, a sinus infection on the left sign of Carsten’s nose.

And sinusitis can cause persistent headaches.

“I think it was in this instance it was coincidence, that he had a sinusitis,” says Dr. Mallory. The entire constellation seem to fit for both, possibly a head injury – but sinusitis can cause the same symptoms.”

Carsten gets antibiotics for his sinusitis, and is sent home.

“Given the findings on the X-ray and given his headache,” says the doctor, “I felt like it was worthwhile to treat him with antibiotics. This is not something that I expect his mother to have picked up, and sometimes it is just an incidental finding.”

What We Need To Know

• Here are some signs that your child may have a sinus infection: A cold lasting longer than 10-to-14 days, sometimes combined with a low-grade fever; a thick, yellow-green nasal discharge; post-nasal drip, sometimes accompanied by a sore throat, cough, bad breath and nausea; swelling around the eyes and irritability. (The American Academy of Otolaryngology – Head and Neck Surgery)
• Sinusitis can be diagnosed by a variety of methods, including laboratory tests (of cultures from the child’s nose or sinus fluid) and also by x-rays, blood tests and/or CAT scan. (Children’s Hospital Boston)
• Antibiotics are the primary medical treatment for sinusitis. A doctor may also order decongestants or mucolytics – to decrease or thin mucous – or cortisone nasal spray, to reduce nasal swelling. (American Rhinologic Society)

Resources

• National Institutes of Health
• Children’s Hospital of Philadelphia
• American Academy of Family Physicians

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