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Sinus Infections in Children
Q: I have trouble with my sinuses. This winter, my five-year-old always seems to have a cold like all the other kids in her class. How do I know if she has a sinus infection? How is it treated?
A: At certain times of the year, it seems that everyone has the "sniffles." Believe it or not, there aren't more germs that cause colds in the winter. It's just that there's closer people-to-people contact since windows and doors are shut because of the cold weather.
Colds usually last about one week. There may be a little fever at the beginning and then lots of sniffling. As a normal cold progresses, you will notice that the discharge from your child's nose changes from watery to green or white and then back to clear before her sniffles stop. Although her symptoms might not be totally gone by 10 days, she should certainly be improving.
Sinus infections are one of the complications of colds as the sinus areas can get clogged easily. The symptoms of a sinus infection are different for children than for adolescents and adults. When a teen or an adult has a sinus infection, the complaints may be face pain, headache, and fever. In children, the signs more commonly are cold symptoms that last beyond 10 days without any sign of improvement or are more severe than you expected. The nasal discharge can be any color. There may or may not be a cough, and if there is a fever it is usually low grade. Your child may not even look very ill. If cold symptoms last beyond 10 days without getting better or are worse than expected, you should speak with your child's doctor.
A diagnosis of sinus infection is usually made by looking at the patient's history and doing a physical exam. X-rays are often not helpful in diagnosing sinus infections.
If your child has a sinus infection, an antibiotic may be recommended for as long as three weeks. Kids often respond quickly within a few days, but finishing the recommended number of days of antibiotics is important. No other medicines are usually necessary. Over-the-counter decongestants haven't been studied much in treating sinus infections and antihistamines should be used only for known allergies.
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Henry Bernstein, M.D., is currently the associate chief of the Division of General Pediatrics and director of Primary Care at Children's Hospital, Boston. He also has an academic appointment at Harvard Medical School.