Thursday, March 26, 2009
Sinusitis and Allergy Q&A
This thread is open for discussion and questions regarding sinus issues in adults and children. I will do my best to offer a physicians perspective when possible. Always keep in mind that I cannot give medical advice in this setting. This can never be a substitue for the advice and care of your own healthcare providers.
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Hello,
ReplyDeleteI have a 1 1/2 year old and he has had a runny/stuffy nose for over a week. It does not seem to be getting better and now it is greenish. How do I know if he needs antibiotics?
WHEN IS A COLD "NOT A COLD"
ReplyDeleteNewmommy raises an interesting dilemna that physicians and parents work through daily. The average child gets between 5 and 7 viral upper respiratory infections yearly. The majority occur during the cold weather seasons. A viral
"cold" is not treated with antibiotics, but must run its own course. Typically, the time course of an upper respiratory virus syndrome is about 5-7 days. The symptoms can be quite severe, with runny nose, sore throat, cough, and fevers variably present. Our general approach to a child with a viral illness is supportive. TLC, acetamenophen (tylenol) for fevers, saline nasal washes, humidification, and time are usually sufficient "treatment" in otherwise healthy children. If the symptoms are severe enough (e.g. high fevers, shortness of breath, listlessness, prolonged poor oral intake) a good medical evaluation is in order. A sinus infection is usually caused by a bacteria and typically requires antibiotic treatment. In my practice, the most reliable indicator is the duration of symptoms. If cold-like symptoms persist for more than the typical 5-7 days, bacterial sinusitis has to be considered. The color of the discharge is very non-specific and can be discolored in both virus and bacterial nasal infections. I hope that this helps you to sort out your concerns.