Symptoms:

The classic symptoms of acute sinusitis in adults usually follow a cold that does not improve, or one that worsens after 5 - 7 days of symptoms. Symptoms include:

• Bad breath or loss of smell
• Cough, often worse at night
• Fatigue and generally not feeling well
• Fever
• Headache -- pressure-like pain, pain behind the eyes, toothache, or facial tenderness
• Nasal congestion and discharge
• Sore throat and postnasal drip

Symptoms of chronic sinusitis are the same as those of acute sinusitis, but tend to be milder and last longer than 12 weeks.

Symptoms of sinusitis in children include:

• Cold or respiratory illness that has been improving and then begins to get worse
• High fever, along with a darkened nasal discharge, for at least 3 days
• Nasal discharge, with or without a cough, that has been present for more than 10 days and is not improving

Signs and tests:

The doctor will examine you or your child for sinusitis by:

• Looking in the nose for signs of polyps
• Shining a light against the sinus (transillumination) for signs of inflammation
• Tapping over a sinus area to find infection

Regular x-rays of the sinuses are not very accurate for diagnosing sinusitis.

Viewing the sinuses through a fiberoptic scope (called nasal endoscopy or rhinoscopy) may help diagnose sinusitis. This is usually done by doctors who specialize in ear, nose, and throat problems (ENTs).

However, these tests are not very sensitive at detecting sinusitis.

A CT scan of the sinuses may also be used to help diagnose sinusitis or to evaluate the anatomy of the sinuses to determine whether surgery will be beneficial. If sinusitis is thought to involve a tumor or fungal infection, an MRI of the sinuses may be necessary.

If you or your child has chronic or recurrent sinusitis, other tests may include:

• Allergy testing
• Blood tests for HIV or other tests for poor immune function
• Ciliary function tests
• Nasal cytology
• Sweat chloride tests for cystic fibrosis