Suggest Treatment For Sinus Infection

Posted on Mon, 18 May 2015

Question: I have been to my ENT twice and he has given ne two courses of antibiotics because of sinus infection. Looked down my throat and said i had lots of pus and saw him 6 days later and pus was gone. Different antibiotics because still had loogies of whitish color. They were greenish in color when i saw him so thats why the antibiotics. I was on the first round of antibiotics which made most green go away but still was spitting clear and white loogies. I just finished second round of 10 days of a different antibiotic and i am still spitting loogies which come from nose and i can sometimes feel from throat. I suck them down from nose and spit. Today my big loogies are greenish and all colors again. Could this be polyups or something worse? I am getting a ct scan of sinuses this week. I am scared its cancer or something. No facial pain my nose at times gets runny but not congested really.

Answered by Dr. Sumit Bhatti (27 minutes later)

Brief Answer:
Definitely not cancer. PND. Sinusitis. Sinus CT. Medication.

Detailed Answer:
Hi,

Thank you for your query.

1. These are definitely not the symptoms of cancer.

2. A severe sinusitis causes a PND (Post Nasal Drip). The changes in color are common and are due to thickening of secretions, white blood cells, bacterial or fungal infections. Get the sputum cultured over three consecutive days for bacteria and fungus.

3. Get a blood test to look for signs of infection (total white blood cell count, ESR-Erythrocyte Sedimentation Rate), type of infection (such as a differential white blood cell count) and any cause for decreased immunity (such as blood sugar levels).

4. The Sinus CT is an important investigation. Get it done and upload the images. Polyps will not get missed on the CT if they are present.

5. In addition to antibiotics, supportive medication such as anti-allergic, mucolytic, anti-inflammatory medication, steam inhalation, saline nasal washes (isotonic and hypertonic) will help settle the nasal discharge.

6. Further treatment options ca be discussed after the CT images and blood reports have been uploaded.

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sumit Bhatti (1 hour later)

So why has the two courses of antibiotics not stoped the mucus and spitting? It seems to have calmed it down a bit especially color. Its been about a month and half with 20 days on antibiotics. Will the ct show what it is? Cancer which u said no, or polyups? What can cause this? I dont feel sick and my only sinus problem was a little runny nose at times very little and this mucus drip. Im scared its something serious! What can this be in your opinion?

Answered by Dr. Sumit Bhatti (8 hours later)

Brief Answer:
Allergic Rhinitis, Post Viral bacterial/fungal overgrowth, Stress related.

Detailed Answer:
Hi,

Thank you for writing back.

1. The nasal discharge may be related in part to allergy, viral / fungal infection or stress. These will not respond to the antibiotic completely. Hence the importance of further tests and supportive treatment.

2. The Sinus CT Scan is the gold standard investigation along with a repeat nasal endoscopy.

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sumit Bhatti (34 hours later)

You said its not paranasal or sinus cancer but what would be signs of that? Like i said my nose dosen't run but a couple times a day i hawk up good loogies and spit them out. Other times throughout the day I kind of pull them down from my nose by sucking down and spitting it out. These ones are either clear or whitish. The good one from nose are all colors. Im afraid but im hoping its polyups or a deviated septum or something. Would my ENT see polyups right away? He didnt stick a tube up or anything yet. He looked down my throat saw pus gave antibiotics. 6 days later after antibiotics the pus was gone but still had some loogies. Switched antibiotics for another ten days and now im still spitting and have my nose loogies. I guess i need answers and im scared. Thanks for caring.

Answered by Dr. Sumit Bhatti (1 hour later)

Brief Answer:
Nasal and Sinus Cancer has many other symptoms.

Detailed Answer:
Hi,

Thank you for writing back.

1. Cancer of the nose and sinuses causes many other symptoms such as severe nasal obstruction, foul smelling nasal discharge, bleeding (epistaxis), watering from the eyes, loosening or painless fall of teeth, swelling, numbness of the face, vision problems, lymph node swellings in the neck and so on.

2. The ENT specialist can see large polyps . Small polyps will require a nasal endoscopy and a Sinus CT Scan to detect.

3. Follow the instructions in my previous answers for settling these issues.

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.

Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj