Pansinusitis may feel like a severe sinus infection but often clears up over time without treatment. However, some cases benefit from medical treatment, such as antibiotics or antifungal medications.
In this article, learn about the causes and symptoms of pansinusitis, as well as when to see a doctor.
Symptoms of pansinusitis may include severe nasal congestion, fever, fatigue, and tenderness in the front of the face.
Pansinusitis occurs when all of the sinuses in the head become infected.
The sinuses are hollow cavities that are located behind the cheeks, forehead, and around the nose. They are lined with mucus that helps trap germs and debris.
Germs are swept down the throat by cilia, which are tiny hairs in the sinuses. When the sinuses are working correctly, this process continuously drains mucus and unwanted substances from the nose and surrounding areas.
If a person is ill, the mucus in the sinuses may build up, preventing the cilia from working properly. The sinuses and nasal passages may swell and cause nasal congestion, which can lead to a painful sinus headache, runny nose, and stuffiness.
If the congestion continues beyond a few days, the sinuses may respond with swelling and inflammation, resulting in sinusitis. If it becomes very severe and affects all the sinuses, pansinusitis may occur.
Sinusitis and pansinusitis should not be confused with rhinitis.
Rhinitis is inflammation and swelling of the nasal passages only and does not involve the sinuses. Doctors often use the term "acute rhinitis" to describe the stuffy nose associated with a cold or allergies.
The most common symptoms of pansinusitis include:
- pressure, tenderness, and pain in the front of the face
- severe nasal congestion
- sore throat from postnasal drip
- thick nasal discharge
- facial pain that radiates into the teeth
- headache in the front of the head
- bad breath
Acute vs. chronic pansinusitis
All cases of pansinusitis have inflamed sinuses in common. But depending on their cause and how long they last, they may be classified in different ways:
- Acute pansinusitis: Symptoms last less than 12 weeks.
- Chronic pansinusitis: Symptoms last longer than 12 weeks.
These infections may also fall into one of the following categories:
- Viral pansinusitis, such as from a cold or flu virus.
- Bacterial pansinusitis, when a bacterial infection causes it.
- Fungal pansinusitis, when symptoms occur due to fungi or mold.
- Allergic pansinusitis, when allergies cause it.
Pansinusitis can also occur because of a physical blockage in the nose or sinuses. An obstruction may make it harder for the sinuses to drain.
Common types of nasal blockages include:
- a deviated septum
- nasal polyps
- narrowed nasal passages
Looking inside the nose may help a doctor to diagnose pansinusitis.
A doctor can diagnose sinusitis in several ways, including:
- discussing the symptoms and checking the sinuses for soreness or tenderness
- looking inside the nose and sinuses
- taking a swab of the inside of the sinuses
- using imaging tests, such as magnetic resonance imaging (MRI) or computed tomography (CT)
For pansinusitis, a CT or MRI will likely be needed to confirm that all sinuses are affected.
Treatment for pansinusitis varies, depending on the underlying cause.
Viral pansinusitis often clears up in 2 weeks or less. Some over-the-counter (OTC) remedies may provide relief from bothersome symptoms.
People can try using pain relievers, decongestants, and saline nasal sprays. Gargling with salt water and baking soda can help relieve an irritated throat from postnasal drip.
A doctor will usually prescribe antibiotics to treat bacterial sinus infections if they do not clear up on their own. However, if a person takes antibiotics too frequently, they no longer work against some types of bacteria. This can make infections more dangerous and harder to treat.
To help prevent this, antibiotics should only be used for pansinusitis when a doctor believes bacteria cause the infection. The Centers for Disease Control and Protection (CDC) also states that antibiotics do not work against most minor sinus infections. They do not work in cases of viruses, fungi or allergies.
Pansinusitis is usually more severe than a minor sinus infection, however. If a sinus infection does not clear up after 2 weeks, a doctor may look more deeply into the cause.
Green nasal discharge is not always an indicator of a sinus infection. A viral infection, such as a cold, can also cause the mucus in the nose to turn green. Significant sinus infections are more likely to have thick nasal discharge with a bad taste in the mouth.
A person with fungal pansinusitis may need to take antifungal medicines if the symptoms do not clear up over time. Fungal sinus infections are more likely to occur in tropical areas and individuals with nasal polyps.
A person may need allergy tests if they have an undiagnosed allergy that causes pansinusitis. If they have a known allergy, antihistamines and other OTC options can help reduce symptoms.
It can help to identify and avoid the allergen when possible. For people with seasonal allergies, many weather programs also indicate high pollen times.
It may be recommended that treatment with allergy shots, which is know as allergy immunotherapy, is given to individuals with persistent chronic sinusitis.
In some cases, surgery may be needed to remove a blockage in the nose. A doctor can remove nasal polyps this way.
A deviated septum or narrow nasal passages can also be corrected. This is only done for chronic and recurring sinus infections.
Most cases of pansinusitis will get better without causing any additional medical problems.
In rare cases, however, pansinusitis can lead to other complications. Medical literature gives examples of ways pansinusitis can cause other issues:
- One case report states that an otherwise healthy 33-year-old man reported double vision after having a headache and nasal congestion for 3 weeks. The symptoms began after he swam in a pool. Doctors diagnosed pansinusitis, probably resulting from bacteria in the pool. Doctors found that one of the nerves in his skull had been temporarily paralyzed (known as palsy) as a result of the pansinusitis. Symptoms resolved after the man took antibiotics.
- Another case report describes a 9-year-old boy who had a drooping eyelid, which is known as ptosis. Using an MRI, doctors determined that pansinusitis had caused the ptosis. After the boy was treated with antibiotics, the ptosis went away.
Some of the sinuses are located close to the brain, so severe pansinusitis could lead to rare but serious infections in the brain. A doctor will evaluate any severe sinus infection to avoid possible complications to the brain.
Not smoking can help prevent pansinusitis.
It is not always possible to prevent pansinusitis, as common ailments such as the cold or flu often contribute to a sinus infection.
Sinus infections, especially pansinusitis, may be more likely to occur in people who have weakened immune systems.
A person can help prevent pansinusitis by:
- Washing their hands thoroughly and often.
- Getting enough rest.
- Eating a varied and nutritious diet to strengthen the immune system.
- Not smoking, as smoking and secondhand smoke weakens the immune system and makes sinus infections more likely.
- Treating allergies or avoiding allergens.
- Avoiding people who are sick with colds or the flu.
- Seeing a doctor if cold or flu symptoms do not improve within 5 days.
- Drinking plenty of clear fluids to help keep nasal mucus thin.
- Using a humidifier to moisturize the air.
- Getting a flu shot each year or as recommended by a doctor.
- Making sure children get recommended vaccines on schedule.
Most people recover completely from pansinusitis, especially if they receive proper medical treatment.
Serious complications are rare, but a person can still speak to a doctor about treatments to reduce symptoms, including pain and congestion.