What color is your snot if you have allergies
American Academy of Allergy, Asthma, and Immunology
This academy’s website provides valuable information to assist readers determine the difference between colds, allergies, and sinusitis. A primer guide on sinusitis also provides more specific information about the chronic version of the illness. Additional resources include a «virtual allergist» that helps you to review your symptoms, as well as a database on pollen counts.
American College of Allergy, Asthma, and Immunology (ACAAI)
In addition to providing a comprehensive guide on sinus infections, the ACAAI website also contains a wealth of information on allergies, asthma, and immunology.
The site’s useful tools include a symptom checker, a way to search for an allergist in your area, and a function that allows you to ask an allergist questions about your symptoms.
Asthma and Allergy Foundation of America (AAFA)
For allergy sufferers, the AAFA website contains an easy-to-understand primer on sinusitis. It also provides comprehensive information on various types of allergies, including those with risk factors for sinusitis.
Centers for Disease Control and Prevention (CDC)
The CDC website provides basic information on sinus infections and other respiratory illnesses, such as common colds, bronchitis, ear infections, flu, and sore throat.
It offers guidance on how to get symptom relief for those illnesses, as well as preventative tips on practicing good hand hygiene, and a recommended immunization schedule.
U.S. National Library of Medicine
The U.S. National Library of Medicine is the world’s largest biomedical library. As part of the National Institutes of Health, their website provides the basics on sinus infection. It also contains a number of links to join you with more information on treatments, diagnostic procedures, and related issues.
Signs and symptoms
Headache or facial pain or pressure of a dull, constant, or aching sort over the affected sinuses is common with both acute and chronic stages of sinusitis.
This pain is generally localized to the involved sinus and may worsen when the affected person bends over or when lying below. Pain often starts on one side of the head and progresses to both sides. Acute sinusitis may be accompanied by thick nasal discharge that is generally green in color and may contain pus or blood. Often, a localized headache or toothache is present, and these symptoms distinguish a sinus-related headache from other types of headaches, such as tension and migraine headaches. Another way to distinguish between toothache and sinusitis is that the pain in sinusitis is generally worsened by tilting the head forward and with the Valsalva maneuver.
Infection of the eye socket is possible, which may result in the loss of sight and is accompanied by fever and severe illness.
Another possible complication is the infection of the bones (osteomyelitis) of the forehead and other facial bones – Pott’s puffy tumor.
Sinus infections can also cause middle-ear problems due to the congestion of the nasal passages. This can be demonstrated by dizziness, «a pressurized or heavy head», or vibrating sensations in the head. Postnasal drip is also a symptom of chronic rhinosinusitis.
Halitosis (bad breath) is often stated to be a symptom of chronic rhinosinusitis; however, gold-standard breath analysis techniques[clarification needed] own not been applied. Theoretically, several possible mechanisms of both objective and subjective halitosis may be involved.
A 2004 study suggested that up to 90% of «sinus headaches» are actually migraines.[verification needed] The confusion occurs in part because migraine involves activation of the trigeminal nerves, which innervate both the sinus region and the meninges surrounding the brain.
As a result, accurately determining the site from which the pain originates is hard.
People with migraines do not typically own the thick nasal discharge that is a common symptom of a sinus infection.
The four paired paranasal sinuses are the frontal, ethmoidal, maxillary, and sphenoidal sinuses. The ethmoidal sinuses are further subdivided into anterior and posterior ethmoid sinuses, the division of which is defined as the basal lamella of the middle nasal concha. In addition to the severity of disease, discussed under, sinusitis can be classified by the sinus cavity it affects:
- Ethmoidal – can cause pain or pressure pain between/behind the eyes, the sides of the upper part of the nose (the medial canthi), and headaches (J01.2/J32.2)
- Maxillary – can cause pain or pressure in the maxillary (cheek) area (e.g., toothache, or headache) (J01.0/J32.0)
- Frontal – can cause pain or pressure in the frontal sinus cavity (located above the eyes), headache, particularly in the forehead (J01.1/J32.1)
- Sphenoidal – can cause pain or pressure behind the eyes, but is often felt in the top of the head, over the mastoid processes, or the back of the head.
|V||Cavernous sinus septic thrombosis|
The proximity of the brain to the sinuses makes the most dangerous complication of sinusitis, particularly involving the frontal and sphenoid sinuses, infection of the brain by the invasion of anaerobic bacteria through the bones or blood vessels.
Abscesses, meningitis, and other life-threatening conditions may result. In extreme cases, the patient may experience mild personality changes, headache, altered consciousness, visual problems, seizures, coma, and possibly death.
Sinus infection can spread through anastomosing veins or by direct extension to shut structures. Orbital complications were categorized by Chandler et al. into five stages according to their severity (see table). Contiguous spread to the orbit may result in periorbital cellulitis, subperiosteal abscess, orbital cellulitis, and abscess.
Orbital cellulitis can complicate acute ethmoiditis if anterior and posterior ethmoidal veinsthrombophlebitis enables the spread of the infection to the lateral or orbital side of the ethmoid labyrinth. Sinusitis may extend to the central nervous system, where it may cause cavernous sinus thrombosis, retrograde meningitis, and epidural, subdural, and brain abscesses. Orbital symptoms frequently precede intracranial spread of the infection .
Other complications include sinobronchitis, maxillary osteomyelitis, and frontal bone osteomyelitis.Osteomyelitis of the frontal bone often originates from a spreading thrombophlebitis. A periostitis of the frontal sinus causes an osteitis and a periostitis of the outer membrane, which produces a tender, puffy swelling of the forehead.
The diagnosis of these complications can be assisted by noting local tenderness and dull pain, and can be confirmed by CT and nuclear isotope scanning.
The most common microbial causes are anaerobic bacteria and S. aureus. Treatment includes performing surgical drainage and istration of antimicrobial therapy. Surgical debridement is rarely required after an extended course of parenteral antimicrobial therapy. Antibiotics should be istered for at least 6 weeks. Continuous monitoring of people for possible intracranial complication is advised.
Health care providers distinguish bacterial and viral sinusitis by watchful waiting. If a person has had sinusitis for fewer than 10 days without the symptoms becoming worse, then the infection is presumed to be viral. When symptoms final more than 10 days or get worse in that time, then the infection is considered bacterial sinusitis. Pain in the teeth and bad breath are also more indicative of bacterial disease.
Imaging by either X-ray, CT or MRI is generally not recommended unless complications develop. Pain caused by sinusitis is sometimes confused for pain caused by pulpitis (toothache) of the maxillary teeth, and vice versa.
Classically, the increased pain when tilting the head forwards separates sinusitis from pulpitis.
Sinusitis (or rhinosinusitis) is defined as an inflammation of the mucous membrane that lines the paranasal sinuses and is classified chronologically into several categories:
- Chronic sinusitis – When the signs and symptoms final for more than 12 weeks.
- Acute sinusitis – A new infection that may final up to four weeks and can be subdivided symptomatically into severe and nonsevere.
Some use definitions up to 12 weeks.
- Subacute sinusitis – An infection that lasts between four and 12 weeks, and represents a transition between acute and chronic infection
- Recurrent acute sinusitis – Four or more full episodes of acute sinusitis that happen within one year
- Acute exacerbation of chronic sinusitis – When the signs and symptoms of chronic sinusitis exacerbate, but return to baseline after treatment
Roughly 90% of adults own had sinusitis at some point in their lives.
For sinusitis lasting more than 12 weeks, a CT scan is recommended. On a CT scan, acute sinus secretions own a radiodensity of 10 to 25 Hounsfield units (HU), but in a more chronic state they become more viscous, with a radiodensity of 30 to 60 HU.
Nasal endoscopy and clinical symptoms are also used to make a positive diagnosis. A tissue sample for histology and cultures can also be collected and tested. Allergic fungal sinusitis (AFS) is often seen in people with asthma and nasal polyps.
In rare cases, sinusoscopy may be made.
Nasal endoscopy involves inserting a flexible fiber-optic tube with a light and camera at its tip into the nose to examine the nasal passages and sinuses.
MRI image showing sinusitis.
Edema and mucosal thickening appears in both maxillary sinuses.
CT scan of chronic sinusitis, showing a filled correct maxillary sinus with sclerotic thickened bone.
X-ray of left-sided maxillary sinusitis marked by an arrow. There is lack of the air transparency indicating fluid in contrast to the other side.
Biofilm bacterial infections may account for numerous cases of antibiotic-refractory chronic sinusitis. Biofilms are complicated aggregates of extracellular matrix and interdependent microorganisms from multiple species, numerous of which may be hard or impossible to isolate using standard clinical laboratory techniques. Bacteria found in biofilms own their antibiotic resistance increased up to 1000 times when compared to free-living bacteria of the same species.
A recent study found that biofilms were present on the mucosa of 75% of people undergoing surgery for chronic sinusitis.
Maxillary sinusitis may also develop from problems with the teeth, and these cases make up between 10 and 40% of cases. The cause of this situation is generally a periapical or periodontal infection of a maxillary posterior tooth, where the inflammatory exudate has eroded through the bone superiorly to drain into the maxillary sinus.
Once an odontogenic infection involves the maxillary sinus, it may then spread to the orbit or to the ethmoid sinus, the nasal cavity, and frontal sinuses, and in unusual instances can spread from the maxillary sinus causing orbital cellulitis, blindness, meningitis, subdural empyema, brain abscess and life-threatening cavernous sinus thrombosis. Limited field CBCT imaging, as compared to periapicalradiographs, improves the ability to detect the teeth as the sources for sinusitis. Treatment focuses on removing the infection and preventing reinfection, by removing of the microorganisms, their byproducts, and pulpal debris from the infected root canal. Systemic antibiotics is ineffective as a definitive solution, but may afford temporary relief of symptoms by improving sinus clearing, and may be appropriate for rapidly spreading infections, but debridement and disinfection of the root canal system at the same time is necessary.
Chronic sinusitis can also be caused indirectly through a common but slight abnormality in the auditory or eustachian tube, which is connected to the sinus cavities and the throat.
Other diseases such as cystic fibrosis and granulomatosis with polyangiitis can also cause chronic sinusitis. This tube is generally almost level with the eye sockets, but when this sometimes hereditary abnormality is present, it is under this level and sometimes level with the vestibule or nasal entrance.
Acute sinusitis is generally precipitated by an earlier upper respiratory tract infection, generally of viral origin, mostly caused by rhinoviruses, coronaviruses, and influenza viruses, others caused by adenoviruses, human parainfluenza viruses, human respiratory syncytial virus, enteroviruses other than rhinoviruses, and metapneumovirus.
If the infection is of bacterial origin, the most common three causative agents are Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. Until recently, H.
influenzae was the most common bacterial agent to cause sinus infections. However, introduction of the H. influenzae type B (Hib) vaccine has dramatically decreased these infections and now non-typable H. influenzae (NTHI) is predominantly seen in clinics. Other sinusitis-causing bacterialpathogens include S.
aureus and other streptococcispecies, anaerobic bacteria and, less commonly, Gram-negative bacteria. Viral sinusitis typically lasts for 7 to 10 days, whereas bacterial sinusitis is more persistent. Around 0.5 to 2.0% of viral sinusitis results in subsequent bacterial sinusitis.
Acute episodes of sinusitis can also result from fungal invasion. These infections are typically seen in people with diabetes or other immune deficiencies (such as AIDS or transplant on immunosuppressive antirejection medications) and can be life-threatening.
In type I diabetics, ketoacidosis can be associated with sinusitis due to mucormycosis.
Chemical irritation can also trigger sinusitis, commonly from cigarette smoke and chlorine fumes. It may also be caused by a tooth infection.
By definition, chronic sinusitis lasts longer than 12 weeks and can be caused by numerous diverse diseases that share chronic inflammation of the sinuses as a common symptom. Symptoms may include any combination of: nasal congestion, facial pain, headache, night-time coughing, an increase in previously minor or controlled asthma symptoms, general malaise, thick green or yellow discharge, feeling of facial fullness or tightness that may worsen when bending over, dizziness, aching teeth, and/or bad breath. Each of these symptoms has multiple other possible causes, which should be considered and investigated, as well.
Often, chronic sinusitis can lead to anosmia, the inability to smell objects. In a little number of cases, acute or chronic maxillary sinusitis is associated with a dental infection. Vertigo, lightheadedness, and blurred vision are not typical in chronic sinusitis and other causes should be investigated.
Chronic sinusitis cases are subdivided into cases with and without polyps.
When polyps are present, the condition is called chronic hyperplastic sinusitis; however, the causes are poorly understood and may include allergy, environmental factors such as dust or pollution, bacterial infection, or fungi (either allergic, infective, or reactive).
Chronic rhinosinusitis represents a multifactorial inflammatory disorder, rather than simply a persistent bacterial infection. The medical management of chronic rhinosinusitis is now focused upon controlling the inflammation that predisposes people to obstruction, reducing the incidence of infections.
However, every forms of chronic rhinosinusitis are associated with impaired sinus drainage and secondary bacterial infections. Most individuals require initial antibiotics to clear any infection and intermittently afterwards to treat acute exacerbations of chronic rhinosinusitis.
A combination of anaerobic and aerobic bacteria is detected in conjunction with chronic sinusitis. Also isolated are S.
aureus, including methicillin-resistant S. aureus, and coagulase-negative staphylococci and Gram-negative enteric bacteria can be isolated.
Attempts own been made to provide a more consistent nomenclature for subtypes of chronic sinusitis. The presence of eosinophils in the mucous lining of the nose and paranasal sinuses has been demonstrated for numerous people, and this has been termed eosinophilic mucin rhinosinusitis (EMRS).
Cases of EMRS may be related to an allergic response, but allergy is not often documented, resulting in further subcategorization into allergic and nonallergic EMRS.
A more recent, and still debated, development in chronic sinusitis is the role that fungi frolic in this disease. Whether fungi are a definite factor in the development of chronic sinusitis remains unclear, and if they are, what is the difference between those who develop the disease and those who remain free of symptoms.
Trials of antifungal treatments own had mixed results.
Recent theories of sinusitis indicate that it often occurs as part of a spectrum of diseases that affect the respiratory tract (i.e., the «one airway» theory) and is often linked to asthma. Every forms of sinusitis may either result in, or be a part of, a generalized inflammation of the airway, so other airway symptoms, such as cough, may be associated with it.
Both smoking and secondhand smoke are associated with chronic rhinosinusitis.
Seasonal allergies and colds share some common symptoms, so it may be hard to tell the two apart.
Both conditions typically involve sneezing, a runny nose and congestion.
There are some differences, though. Additionally, colds generally include coughing and a sore throat, but these symptoms can also happen in people with hay fever who own post-nasal drip.
Itchy eyes are common for seasonal allergies, but rare for colds.
«Colds and seasonal allergies seem extremely similar in numerous ways,» said Dr. Rima Rachid, director of allergen immunotherapy at Boston Children’s Hospital. «It’s the duration [length] and chronicity [frequency] of symptoms that might assist tell the difference,» she explained.
It’s not unusual for parents and even doctors to confuse freezing and seasonal allergy symptoms, Rachid told Live Science.
Young children frequently get colds, and their parents may not always ponder of seasonal allergies as the reason for kids’ constantly drippy noses.
Seasonal allergies may first show up in a kid at around ages 4 to 6, but they can also start at any age after that, Rachid said.
And genetics frolic a role: People with one parent who has any type of allergy own a 1 in 3 chance of developing an allergy, Rachid said. When both parents own allergies, their children own a 7 in 10 chance of developing allergies, too.
Here are five signs to glance for to determine whether symptoms are due to seasonal allergies or a cold.
Consider the time of year. Colds tend to happen in the winter, and they often take several days to show up after exposure to a virus.
With seasonal allergies, the onset of symptoms — the sneezing, stuffy nose and itchy eyes — happen immediately after exposure to pollens in spring, summer or drop. If symptoms tend to show up the same time every year, it may well be seasonal allergies rather than a freezing. [9 Weirdest Allergies]
Duration of symptoms matters. The symptoms of a freezing typically final three to 14 days, but allergy symptoms final longer, generally for weeks, as endless as the person is exposed to pollen, Rachid said.
Color of nasal discharge offers clues. When she sees a patient with green or yellow mucus, Rachid said, she tends to ponder the person has a freezing or infection.
Seasonal allergies generally produce clear nasal secretions, she said, although sinus infections may confuse the picture. Sometimes allergy sufferers develop sinus infections, which can result in yellow-colored nasal discharge.
Any temperature or muscle aches? Despite the name «hay fever,» seasonal allergies don’t generally cause fever or body aches, whereas people with a freezing often own these symptoms.
Notice «the allergic salute.» Parents may notice children frequently pushing their noses up with the palms of their hands to wipe or relieve itchiness — this could be a telltale sign of seasonal allergies.
When trying to determine if a child’s symptoms are due to a freezing or seasonal allergies, Rachid often asks parents about «the allergic salute.» She also observes the skin on the child’s nose, since the «salute,» when done frequently, tends to cause a little crease at the bridge.
«Anyone with a freezing may do the allergic salute, but children with allergies tend to do this a lot,» Rachid said. It means something is bothering them, and could indicate their allergies are getting worse, she explained.
FollowLive Science @livescience, &+. Original article on Live Science.
- What triggers it: A virus.
- What it feels like: You can expect a stuffy nose, but also some runny, discolored mucus, Goldsobel explains.
You may also experience a sore throat, cough, sneezing, headache, or fatigue. Another sign is a rising temperature: Colds often trigger a fever, he says, but sometimes those fevers are so mild that people ponder they own allergies instead.
- How endless it lasts: People generally fend off the freezing virus (without treatment) within seven to 10 days, Baroody says. But if your symptoms own lingered past that window of time, you might own sinusitis. If you suspect you own a sinus infection, you should talk to your doctor.
An Allergic Reaction
- What triggers it: Allergens cause an allergic reaction.
Common indoor allergens include mold, dust, and animal dander, while outdoor triggers include pollen and ragweed.
- What it feels like: You may experience some nasal congestion with allergies, but it generally accompanies a runny nose (clear, watery discharge), sneezing, and itchy nose and eyes. Allergies never cause a fever, Goldsobel notes.
- How endless it lasts: If you own seasonal allergies, you may struggle with allergy symptoms throughout the spring and drop, Dr.
Baroody says. If you're allergic to indoor allergens, you may experience symptoms year-round.
How to Treat Congestion
Because sinus infections, colds, and allergies share some similar symptoms, including congestion, medications love nasal sprays, oral antihistamines, and eye drops can assist minimize your discomfort.
If allergies are to blame, do your best to avoid your known triggers and steer clear of any other potential irritants, such as smoke or air pollution. Long-term treatments love immunotherapy (allergy shots) can assist desensitize you to allergens and improve symptoms over time.
When Colds and Allergies Cause Sinus Infections
Even if your sinus congestion is being caused by allergies or a freezing, it doesn’t mean you won’t develop a sinus infection later on.
In fact, when people own colds or allergies, the lining of the nose will swell up, which prevents mucus from draining properly — and that can then lead to sinusitis, says Goldsobel.
People with allergies and asthma may be more vulnerable to sinusitis, though it's not proven, Baroody says.
If you are at higher risk for sinus infections, you can take steps to prevent them. Don't let allergy symptoms spiral out of control. And, Baroody says, be on the lookout "for the symptoms of sinus infections, and treat them promptly."
How to Stay Healthy, Breathe Easier, and Feel Energetic This Winter
Indoor allergies, freezing weather, less sunlight — winter can make it hard to stay well mentally and physically.
Discover out how to protect yourself against seasonal allergies, the winter blahs, freezing winds, comfort-eating traps, and fatigue this year.
Learn More About the Ultimate Winter Wellness Guide
Sinusitis can be a confusing thing to treat for anyone. Because a sinus infection can be so easily confused with a common freezing or an allergy, figuring out the best way to alleviate your symptoms can be difficult.
Even more challenging, a sinus infection can evolve over time from a viral infection to a bacterial infection, or even from a short-term acute infection to a long-term chronic illness.
We own provided for you the best sources of information on sinus infections to assist you rapidly define your ailment and get the best and most efficient treatment possible.
Favorite Resources for Finding a Specialist
American Rhinologic Society
Through research, education, and advocacy, the American Rhinologic Society is devoted to serving patients with nose, sinus, and skull base disorders.
Their website’s thorough coverage of sinus-related issues includes rarer conditions, such as fungal sinusitis, which are often excluded from other informational sites. It also provides a valuable search tool to discover a doctor, as well as links to other medical societies and resources that are useful for patients.
Their website contains an exhaustive guide on sinusitis and an easy-to-use «Find a Doctor» search tool.
ENThealth provides useful information on how the ear, nose, and throat (ENT) are all connected, along with information about sinusitis and other related illnesses and symptoms, such as rhinitis, deviated septum, and postnasal drip.
As part of the American Academy of Otolaryngology — Head and Neck Surgery, this website is equipped with the ability to assist you discover an ENT specialist in your area.
For the joint inflammation condition, see Synovitis.
Inflammation of the mucous membrane that lines the sinuses resulting in symptoms
|Other names||Sinus infection, rhinosinusitis|
|A CT scan showing sinusitis of the ethmoid sinus|
|Symptoms||Thick nasal mucus, plugged nose, pain in the face, fever|
|Causes||Infection (bacterial, fungal, viral), allergies, air pollution, structural problems in the nose|
|Risk factors||Asthma, cystic fibrosis, poor immune function|
|Diagnostic method||Usually based on symptoms|
|Prevention||Handwashing, avoiding smoking, immunization|
|Treatment||Pain medications, nasal steroids, nasal irrigation, antibiotic|
|Frequency||10–30% each year (developed world)|
Sinusitis, also known as rhinosinusitis, is inflammation of the mucous membranes that line the sinuses resulting in symptoms. Common symptoms include thick nasal mucus, a plugged nose, and facial pain. Other signs and symptoms may include fever, headaches, a poor sense of smell, sore throat, and a cough. The cough is often worse at night. Serious complications are rare. It is defined as acute sinusitis if it lasts fewer than 4 weeks, and as chronic sinusitis if it lasts for more than 12 weeks.
Sinusitis can be caused by infection, allergies, air pollution, or structural problems in the nose. Most cases are caused by a viral infection. A bacterial infection may be present if symptoms final more than 10 days or if a person worsens after starting to improve. Recurrent episodes are more likely in persons with asthma, cystic fibrosis, and poor immune function.X-rays are not generally needed unless complications are suspected. In chronic cases, confirmatory testing is recommended by either direct visualization or computed tomography.
Some cases may be prevented by hand washing, avoiding smoking, and immunization.Pain killers such as naproxen, nasal steroids, and nasal irrigation may be used to assist with symptoms. Recommended initial treatment for acute sinusitis is watchful waiting. If symptoms do not improve in 7–10 days or get worse, then an antibiotic may be used or changed. In those in whom antibiotics are used, either amoxicillin or amoxicillin/clavulanate is recommended first line. Surgery may occasionally be used in people with chronic disease.
Sinusitis is a common condition. It affects between about 10 and 30 percent of people each year in the United States and Europe. Women are more often affected than men. Chronic sinusitis affects about 12.5% of people. Treatment of sinusitis in the United States results in more than US$11 billion in costs. The unnecessary and ineffective treatment of viral sinusitis with antibiotics is common.