HJBR Jan/Feb 2020

HEALTHCARE JOURNAL OF BATON ROUGE I  JAN / FEB 2020 17 spreading it to vulnerable people in your community (such as the very young and the elderly). If you’re not motivated to pro- tect yourself from the flu with the flu vac- cine, consider doing it as an act of service for others who are at risk for serious com- plications from the flu. Acute sinusitis, which is inflammation of the nasal cavity and sinuses lasting less than four weeks, is also often caused by a virus. In 0.5-2 percent of cases, acute sinus- itis is bacterial. Acute sinusitis may include many of the symptoms listed above, with an increased feeling of facial pressure and pain, tooth discomfort, and ear fullness. Your sinus infection is more likely to be bacterial if your symptoms haven’t started improving after ten days, or you experi- ence the phenomenon of “double sicken- ing.”Double sickening is characterized by a worsening of symptoms after your original symptoms were noticeably improving, and this can indicate that bacteria has second- arily infected your sinus cavity after a viral infection.While bacterial sinusitismay result in more severe symptoms (e.g., fever >102 degrees), severity of illness alone is not suf- ficient to treat for possible bacterial sinus- itis without a history of more than 10 days of illness or double sickening.  When you suspect you have a sinus infec- tion, you can simply wait it out or you can start the symptomatic therapies that will likely be recommended by your physician. You can use anti-pyretic (fever-lowering) medications such as Tylenol and ibupro- fen, which will help reduce your malaise and body aches. You can consider using intranasal glucocorticoids, such as Flonase. You should consider saline nasal irrigation using a system such as NeilMed to flush and cleanse your nasal and sinus passageways. Saline irrigation is likely to be more helpful when your nose is only partially congested, as a high level of congestion may impede flow of the saline. The good news about bacterial sinusitis? Like viruses, most cases are self-limiting, meaning they resolve on their own without the use of medication, usually within two weeks. Patients treated with antibiotics usu- ally experience a shorter course of symp- toms, but they also experiencemore adverse events, such as side effects fromantibiotics. Once the diagnosis of bacterial sinusitis is made, it is recommended for a physician to wait seven days before initiating antibacte- rial therapy in order to allow the bacterial infection a chance to self-resolve.  Serious complications from bacterial sinusitis are rare and include extension of bacteria from the sinuses to the central ner- vous systemand space surrounding the eye. Warning signs to seek immediate medical attention include swelling around your eyes, painful eye movements, vision changes, neck stiffness, and an altered mental status (such as confusion).  In summary, see a doctor if your cold symptoms fail to noticeably start improving within ten days of symptomonset, or if your symptoms improve, but then worsen again. At that point, a bacterial sinus infection will likely be suspected. After the diagnosis of a bacterial sinus infection is made, your phy- sician will likely offer you antibiotics, but it is a very reasonable (and recommended) strategy to wait seven additional days before initiating antibiotic therapy in order to allow the bacterial infection a chance to resolve on its own.Always visit your doctor or an emer- gency room if you are experiencing short- ness of breath, high fevers, or respiratory symptoms in the setting of a known lung disease, such as chronic obstructive pulmo- nary disease (COPD) or asthma. As always, prevention is best. Reduce the risk of contracting the cold and flu this sea- son by getting a flu shot, washing your hands often, and boosting your immune systemby staying as well-rested and hydrated as pos- sible. n SOURCES https://www.uptodate.com/contents/ the-common-cold-in-adults-diagnosis-and- clinical-features?search=common%20 cold&source=search_result &selectedTitle=3~150&usag e_type=default&display_rank=3#H11414490 https://www.uptodate.com/ contents/uncomplicated-acute- sinusitis-and-rhinosinusitis-in- adults-treatment?search=acute%20 sinusitis&source=search_result&selectedTitle =1~146&usagetype=default&display_rank=1 https://www.uptodate.com/contents/ treatment-of-seasonal-influenza-in-adults?se arch=influenza&source=search_result&select edTitle=1~150&usage_type=default&display_ rank=1#H2855203613 “Always visit your doctor or an emer- gency room if you are experiencing shortness of breath, high fevers, or respiratory symptoms in the setting of a known lung disease, such as chronic obstructive pulmonary disease (COPD) or asthma. ”