What happens if a sinus infection goes untreated?

A mild case of acute sinusitis can be treated at home with over-the-counter medications and natural remedies like nasal irrigation, decongestants, steam inhalation, rest and plenty of fluids. Sinus infections that linger for weeks or months can require more intense treatment. Antibiotics and medication directed at the sinus inflammation may return normal sinus function.  Surgery can be an option in cases of recurrent acute sinusitis or chronic sinus infections.

Most sinus infections will resolve in a week or two. However, there are rare cases of serious and potentially life-threatening complications that may arise. Knowing what the signs and symptoms of these complications can keep a complication from becoming a catastrophe.

The thin sinus walls share a border with the surrounding tissue including the eyes, brain and major nerves and blood vessels. A sinus infection can sometimes spread beyond the border of the sinuses. Read below about the potential rare consequences of an untreated sinus infection.

In rare situations, the failure to treat a sinus infection can lead to a serious complication.

Infection Of The Eye

Infected sinuses are particularly dangerous due to their proximity to the eyes and brain. A sinus infection can spread along the pathways of blood vessels or the nervous system. Children are at higher risk for sinus infection complications in the eyes since their facial bones are still maturing and opens between the sinuses and the eye sockets have not yet closed.

The sinus infection that spread to the eye socket lead to an increase in swollen tissue around the eyes. As a result, the eyes can look puffy or swollen shut. In some cases, the swollen might occur behind the eyes, pushing the eyes forward in the socket and preventing the eyelids from closing.

The eye socket is a very small, enclosed area, meaning that swelling can cause increased pressure that can lead to permanent eye damage. The infection can spread causing meningitis an even death. If you have severe eye pain or visual loss you should seek medical attention immediately.

Brain Infection

In rare cases, an untreated sinus infection can spread to the brain or to the tissue surrounding the brain. If the infection spreads to the tissue of the brain, then you are at risk for seizures, brain damage or even death. Bacterial meningitis and even a brain abscess can occur leading to hearing loss, stroke, permanent brain damage, and even death.

The black arrows point to a brain abscess, a severe consequence of untreated sinusitis.

If you show signs of meningitis (headache, fever, nausea and stiff neck) or if you have a sudden change in your mental status or loss of function of part of your body you should seek medical care immediately.

Infection Of The Bone (Osteomyelitis)

Both recurrent acute sinusitis and chronic sinus infections can spread to the bone surrounding the sinuses. This infection can enter blood vessels and send bacteria to the brain or other parts of the body. Infected bone is very difficult to cure. Treatment is generally long-term intravenous antibiotics.

Mucoceles

An untreated chronic sinus infection can alter the normal functions of your nose over time. A mucocele is a collection of mucus in the sinus that slowly expands over time. The pressure from the mucocele can erode or remodel bone adjacent to it and even herniate through the bone into the surrounding structure like the eye and brain. Symptomatic mucoceles require surgical drainage.

Asthma

Sufferers of asthma are also likely to be negatively affected by an untreated sinus infection. Research shows that infections can not only aggravate, but worsen asthma. Because sinus infections affect one’s ability to breathe normally, any pre-existing breathing conditions, like asthma, are therefore also affected.

06/15/2016

A sinus infection (or sinusitis) occurs when the tissue lining in your sinus cavity becomes swollen or inflamed. When your sinuses are blocked, they become a breeding ground for bacteria and viruses that can lead to an infection. That’s why it’s best to visit your doctor at the first signs of a sinus infection. Otherwise, it could lead to a chronic condition. Here’s how to know if your sinus infection has developed into something more dangerous:

Swelling

If you experience swelling around your eyes, this can be a red flag for severe sinusitis. You may just be having an allergic reaction, or it could be something more concerning like an infection in your eye. Ask your doctor about using over-the-counter anti-inflammatories to ease the swelling.

Pain

When there is excessive pain in your eyes, ears, head or throat, you likely have a severe sinus infection. And if you can’t open your eyes or you feel dizzy, these are major warning signs that your sinusitis is at a dangerous level. If not properly treated, you may incur infections in your ears, throat and even your brain (called meningitis.)

Fever

Your body’s natural way of eliminating infection is typically accompanied by a low-grade fever. But if your pain and other symptoms are compounded by a fever greater than 101 degrees, see your doctor. It may mean the infection has spread.

Feeling Disoriented

If you find yourself confused about a task you’re performing or if you forget basic information, it may be a sign that the infection has affected your brain. Seek medical attention at once.

A Persistent Infection

Most sinus infections last from a couple of days to a few weeks and are not a serious medical concern, but if left untreated, sinusitis can lead to further complications. These include nasal polyps, a deviated septum and serious allergies. If your infection doesn’t go away after four weeks, it’s time to call your doctor.

For more information about identifying and treating a sinus infection, or to learn more about the other services we provide, please call our office at 732-280-7855 or visit our website.

If you let sinus infection go untreated, it could lead to rare but serious complications such as chronic sinusitis that spreads to the surrounding areas and the larynx, eyes, and brain. Potential complications of untreated sinus infection include:

• Chronic sinusitis
• Difficulty breathing
• Hyposmia (reduced sense of smell)
• Anosmia (complete loss of the sense of smell)
• Laryngitis (inflammation of the larynx)
• Dacryocystitis (inflammation or infection of the lacrimal glands)
• Orbital cellulitis or abscess (inflammation of the orbit of the eye)
• Meningitis (inflammation of the meninges)
• Brain abscess (pus-filled pockets inside the brain)
• Frontal bone osteomyelitis (infection of the frontal bone)
• Cavernous sinus thrombosis (formation of blood clot forms inside a hollow space at the base of the brain)

A sinus infection that lasts longer than a month without treatment requires a visit to the ear, nose, and throat (ENT) doctor. If your sinus infection does not clear after 12 weeks of antibiotic therapy, it needs to be treated more aggressively.

What causes sinusitis?

Sinusitis is the inflammation or infection of the sinuses, which are empty spaces between the eyes and cheekbones. These empty spaces normally drain fluid into the nose and throat. If they become blocked however, due to dust, pollution, or microbes (viruses, bacteria, or fungi), it can result in sinusitis.

Conditions that can cause sinus blockage include:

• Common cold (the same virus that causes the common cold often causes sinusitis)
• Allergic rhinitis (swelling of the lining of the nose caused by allergens such as pollen)
• Nasal polyps (small, fleshy growths in the lining of the nose)
• Deviated nasal septum (tilting of the middle bony part or nasal septum in the nostrils toward either side)

What are the stages of a sinus infection?

Stages or types of sinus infection are classified depending on how long the symptoms last:

• Acute sinusitis: Starts with a runny or stuffy nose and facial pain and lasts for 2-4 weeks.
• Subacute sinusitis: Symptoms persist for 4-12 weeks.
• Chronic sinusitis: Symptoms linger beyond 12 weeks.
• Recurrent sinusitis: Repeated attacks of sinusitis several times a year.

How is sinusitis diagnosed?

Your doctor will take your medical history, ask about your symptoms, and perform a physical examination to make a diagnosis of sinusitis. During the physical exam, your doctor will check the inside of your nose with a speculum and flashlight. 

Though not routinely ordered, tests done to diagnose sinusitis include:

• Blood tests: Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) can determine the severity of the infection.
• Culture test: This involves taking a sample of discharge (swab) of the nose or sinus to detect the presence of microorganisms.
• Allergy test: This is usually done if you develop recurrent sinus infections.

How is sinusitis treated?

In the initial stages of sinusitis, you can manage symptoms the way you would a viral sinus infection, which goes away within 10-14 days:

• Drink plenty of fluids.
• Apply a warm towel on your face for 5-10 minutes at a time 5 times a day.
• Inhale steam from a hot shower or bath.
• Use saline nasal drops in your nostrils, which loosens trapped mucus.
• Try over-the-counter medications such as nasal decongestants to help relieve pain and pressure in the head and face.

If your sinus infection does not clear up within 14 days, it may be due to bacteria or fungi:

• If it is a bacterial infection, it will need to be treated with antibiotics. 
• If it is a fungal infection, your doctor will prescribe antifungal medicines, steroids, or surgery (in severe cases).

If you have persistent sinus problems, your doctor may recommend surgery to open the blocked sinuses or to create a wider sinus opening. Surgical options include:

• Simple balloon sinuplasty and irrigation (use of small balloon catheters that inflate to drain the nasal sinuses)
• Endoscopic sinus surgery (removal of tissue and bone to create a wider opening)

Medically Reviewed on 2/24/2022

References

Image Source: iStock Images Brook I. Acute Sinusitis. Medscape. https://emedicine.medscape.com/article/232670-overview

Brook I. Chronic Sinusitis. Medscape. https://emedicine.medscape.com/article/232791-overview