Inflammation of the sinuses of the face is called sinusitis. Headaches and facial pain in sinusitis will be excruciating, especially if you have chronic sinusitis that has not improved even with antibiotics. In the following, we will tell you about “Sinus infections antibiotics not working”
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What is sinus? What does sinusitis mean?
The sinuses are hollow, moist cavities located inside the bones of the face. These cavities are emptied through the nose. When there is an infection, or the nose is blocked for any reason, or the nasal mucosa is swollen (whether due to infection or allergies), the sinusitis outlet is blocked and the sinuses drain, causing inflammation of the blocked sinus wall and sinusitis. Is created.
Causes of sinusitis
Closing the exit hole and draining the sinus is the main cause of sinusitis. The causes of this blockage are:
- Existence of nasal polyps
- Tumor
- Infection, inflammation and swelling of the tissue
- Deviation of the nasal septum
- Dealing with allergens:
People with allergies are more likely to develop sinusitis
Allergens cause constant irritation of the mucous membranes and increase the pressure inside the nose and sinuses
Cigarette smoke, allergens, air pollution, dust, etc. can cause sinusitis by causing non-infectious inflammation.
- Infections:
- Viral:
Viral sinusitis usually resolves within a week and finally ten days.
- Bacterial:
Bacteria can also cause inflammation and infection of the sinus wall mucosa. For example, if you have had a simple viral cold and your sinusitis has not improved for seven to ten days now, or if there is now purulent discharge from your nose and increased coldness and pain in your face, it is likely that bacterial sinusitis followed by viral sinusitis. Inflammation and swelling caused by a viral infection in the mucosa of the nasal wall, blocking the exit hole and the sinus drainage site. And the bacteria get trapped inside the sinuses and cause infections and purulent discharge that will require treatment with appropriate antibiotics.
- Unusual infections:
Most sinus infections go away with proper antibiotics during treatment, but sometimes there are sinus infections that have not responded to antibiotic treatment at all.
Fungal infections can cause sinus infections that are also resistant to common treatments and antibiotics. In most cases, fungal infections of the sinuses occur in people with defective immune systems, such as people with uncontrolled diabetes, people undergoing chemotherapy or taking Long-term immunosuppressive drugs.
- People with certain syndromes or immunodeficiency syndromes:
For example, people with CF or cystic fibrosis
- Some autoimmune diseases:
Vasculitis Wegener
Why are some sinus infections not treated with antibiotics?
The cause of your sinusitis, especially when it becomes chronic (sinusitis that lasts more than three months), may not be bacterial at all, for example.
There is a defective immune system and the person has a fungal sinus infection or opportunistic factors.
For example, mucormycosis is an infection caused by a fungus that affects the nose, sinuses, and eyes.
The person is more likely to have a person with uncontrolled diabetes who has seen a doctor with chronic discharge or bad breath.
People undergoing chemotherapy and people with a variety of immunodeficiency syndromes can also experience fungal sinus infections. And other so-called opportunistic infections that occur in people with defective immune systems.
Of course, these infections will not improve with conventional antibiotic treatments, and in addition to fungal infections of the sinuses, despite the prescription and use of antibiotics, they still exist and will worsen day by day.
Death of surrounding tissues and bones is noticeable, And there have been people who, due to negligence in the treatment of sinus fungal infections with mucous fungus, the doctor has been forced to empty their eyes due to the spread of the infection.
Fungal sinusitis
They are caused by fungi entering the facial sinuses
Fungal sinusitis is divided into two general categories:
- Intensive:
These infections can cause corrosion !! in the bones between the sinuses and the eyes, spread to surrounding areas, and cause deformities in the face and eyes. The risk of recurrence of these sinus infections is very high and they will not respond to antibiotics at all and usually have to be operated on due to their injuries and risks. After surgery, it is necessary to take special measures and long-term follow-up. The recurrence depends on the degree of cooperation and observance of care points by the patient.
- Non-invasive:
In general, fungi are responsible for five to ten percent of all chronic sinus infections
The two types of fungi that can cause sinus infections and do not respond to antibiotics are:
- Mucor (more common)
- Aspergillus
Sinus infection with mucous fungus
This fungus is very progressive and aggressive. Affected people generally have an underlying disorder such as uncontrolled diabetes, cancers, taking immunosuppressive drugs, and so on.
Surgery is performed based on the extent of the lesion in the following different ways:
- first group:
People in whom the infection is limited to the sinuses and nose
Cleansing and debridement of sinuses and noses
- The second group:
People with ocular involvement
Drain the eyeball
- The third group:
Penetration of fungal infections into the brain
Unfortunately, at this stage, treatment and surgery will be unsuccessful and will not affect the survival rate of the patient.
Symptoms of fungal sinusitis
- Feeling of burning eyes:
- Facial and cheek numbness
- Black lesions on the roof of the mouth or on the wall of the nose
This type of sinus infection will not improve despite antibiotic treatment
This type of sinus infection is resistant to common antibiotic treatments.
A person with a fungal sinus infection may have a bacterial sinus infection at the same time, but the sinusitis will not improve until the fungus is treated.
The most important factor in the treatment of antibiotic-resistant sinus fungal infections is their early detection. Both the diagnosis and treatment of sinus fungal infections are difficult, and the only possible way is endoscopic sinus surgery.
So if you or those around you have undergone chemotherapy, or are taking immunosuppressive drugs, or have diabetes that is not well controlled and you currently have chronic sinusitis with a foul-smelling discharge, be sure to see a doctor as soon as possible. Delayed treatment can lead to facial structure damage, eye emptying, brain involvement and death.
Symptoms of chronic allergic sinusitis
- Cough
- Nasal congestion
- Feeling of pressure and fullness of the face
- Facial pain
- Nasal discharge
- toothache
- Bad smell of mouth
- Fatigue
These sinusitis infections do not require antibiotics until your doctor finds out about a bacterial infection.
In these allergic sinusitis, the following is more important than antibiotic treatment, which will often be ineffective:
- Rinse the inside of the nose with saline solution or normal saline for rinsing.
- It is recommended to use distilled water instead of using tap water that contains chlorine
- After exposure to some allergens, for example:
After gardening or crossing fields during the pollination season
After being in polluted environments such as factories and production and industrial workshops
And being exposed to car smoke and polluted air
Take a quick shower when you get home, wash your hands and face with unscented soaps, and clean your nose with normal saline.
Drink plenty of fluids and water to keep your nasal mucosa and sinuses from drying out. Do not walk in cold, dry air without a hat or scarf.
Other causes of sinusitis
- Immune disorders:
Sometimes there are congenital defects in the immune system that make people more susceptible to recurrent airway and sinus infections. In cases where your child’s respiratory infections are high, there is a shortening of the gap or there is a prolonged sinus infection that is resistant to antibiotic treatment. Additional and subspecialty studies will definitely be needed.
- Cystic fibrosis and sinusitis:
It is the most common genetic disorder in children, adolescents and young people. The airways of people with CF are very thick and sticky, the sinuses are often filled with thick secretions and the walls of the sinuses become inflamed, nasal polyps are common in these people, CF may even lead to corrosion of the facial bones.
Treatment of chronic sinusitis
Sometimes it is necessary to use injectable antibiotics in chronic sinusitis resistant to oral antibiotics.
Regular nasal lavage and inhaled corticosteroids are other treatments that your doctor will recommend.
In antibiotic-resistant infectious sinusitis, there may be drug resistance. Unfortunately, in developing countries, improper and careless use of antibiotics has made many types of bacteria resistant to common antibiotics. Your doctor will prescribe an antibiotic that can solve your problem.