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Symptoms of acute sinusitis
Last reviewed: 04.07.2025
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In newborns and infants, the disease in the form of ethmoiditis develops rapidly and is severe. The catarrhal form is almost never diagnosed, since the disease turns into a purulent form within a few hours. General symptoms prevail over local ones: a sharp deterioration in the condition, hyperthermia, anxiety of the child, regurgitation, vomiting. The child's nasal breathing is impaired, and as a result, there is a refusal to eat. In addition, shortness of breath is noted, especially when the child is lying down, and the appearance of swelling in the area of the angle of the eye socket, discharge from the nose. By the end of the first - second day of the disease, swelling of the eye socket is noted, the eye is closed or half-closed, lacrimation and hyperemia appear.
The rhinoscopic picture in the first 2 days of the disease is characterized by hyperemia and edema of the mucous membrane, which complicates the examination. Later, on the 3rd-6th day of the disease, prolapse of the lateral wall of the nose, narrowing of the passages, and viscous purulent discharge appear, which flows down the back wall of the pharynx. At this time, the appearance of a rough, "tracheal" cough is characteristic, which intensifies in the supine position and is caused by the flow of discharge from the nasal passages into the pharynx and larynx - the so-called drip syndrome.
In older children, sinusitis, frontal sinusitis and sphingoiditis usually develop on the 5th-6th day of acute respiratory disease, acute nasopharyngitis.
As a rule, after a 1-2-day improvement in the patient's condition, the temperature rises again, the general condition worsens, nasal congestion reappears, nasal breathing becomes difficult, if there is discharge from the nose, it becomes mucopurulent or purulent, viscous, stringy, and difficult to remove. Children complain of pain in the ears, in the upper jaw, in the forehead. Pain is especially characteristic when there is almost no discharge, there is only severe nasal congestion, i.e. when the nasal passages are obstructed due to tissue edema. During this period, pain is characteristic when tapping on the projections of the nasal sinuses. Also characteristic is the appearance of a rough cough, which intensifies when the patient lies on his back (drip syndrome).
Complications of acute sinusitis
On the 3rd-5th day of the disease, complications may develop due to the spread of the purulent-inflammatory process to the periosteum with the formation of a subperiosteal abscess, a fistula of the nasal cavity floor, the alveolar and frontal process of the maxilla in ethmoiditis. The development of phlegmon or an abscess of the tissues of the orbit in sinusitis and ethmoiditis. Sepsis, purulent meningitis, an abscess of the frontal lobe of the brain (in frontal sinusitis), and thrombosis of the cavernous sinus (in sphingoiditis) may develop.
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