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Respiratory Disorders (Expert Forum)
Sinus ifection for 3 months
Answered by
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Sinus ifection for 3 months
by tikicat, May 16, 2003 12:00AM
I have had an ongoing sinus infections for the last 3 months. I have had 5 rounds of antibiotics, which have helped while I am taking them - just as soon as I get off of them I am miserable again. I use flonase, zyrtec, nasalcrom and allegra d and a prescription decongestant to relieve the extreme congestion in my neck. I also do nasal washes every other day. I should add to this that I have an immune deficiency - CVID. I cannot kick this sinus trouble. I have a constant low fever, have lost my sense of smell and have even been to the dentist to see if I had cavities in my upper teeth as they hurt so much. I also live where the Mexican fires smoke have been affecting us and have alot of allergy trouble in my eyes and throat. What else can I try for relief? All of my drainage is down my throat, nothing out the nose - but when it is it is green.
Doctor's Answer
by National Jewish, May 23, 2003 12:00AM
, May 23, 2003 12:00AM
With common variable immune deficiency (CVID) your immunoglobulin G (IgG) is low. IgG is a part of your immune system that helps you to fight infections. When the IgG level in your blood is low it can be harder for you to fight infections. Recurring infections are the most common problem with CVID. These commonly include sinus and chest infections. Replacement therapy with intravenous gammaglobulin is the treatment for CVID. This will raise your IgG levels so that you can fight infections better. Please read our Immune Deficiencies MedFact at http://www.nationaljewish.org/medfacts/immune.html for more information.
Sinusitis is an inflammation, or swelling, of the mucous membranes that line the sinus cavities. This can block sinus drainage and cause increased mucus production. Symptoms can include a headache or pressure in the area of the sinuses, a stuffy nose, achy teeth, postnasal drip, cough, sore throat, laryngitis, constant low fever, and thick, yellow to green nasal drainage.
The most common cause of sinusitis is an infection, especially when the mucus is green. Sinus infections can be difficult to treat since they respond slowly. When a bacterial infection is the cause you may need to take an antibiotic for 2 weeks or longer. Even after the antibiotic clears the infection, it is possible for the inflammation to linger. However, inflammation of the sinuses could also be due to an allergy or chronic exposure to an irritant, such as the smoke from the Mexican fires.
Drainage from the nose and sinuses that drips down the back of the throat is known as postnasal drip. This can fester sinusitis. An antihistamine like Allegra® (fexofenadine) and Zyrtec® (cetirizine) can dry up the postnasal drip. However, it may make the mucus thicker and more difficult for you to blow out of your nose. A decongestant can relieve your blocked sinuses and thin the postnasal drip so it drains better.
Your sinuses can be very important to your sense of smell. When the drainage of your sinuses is blocked, you may lose your sense of smell. Until the blockage is cleared your sense of smell will not return. A nasal wash helps remove mucus and bacteria from the nose and sinuses. This can temporarily reduce the postnasal drip and help your sinuses to drain better. You may have short-term return of your sense of smell, but you may lose it again because the blockage is not completely cleared. Please read our Nasal Wash MedFact at http://www.nationaljewish.org/medfacts/nasal.html for more information about this daily treatment.
Since your sense of smell hasn’t returned, your doctor recommended following the nasal washes regularly with the prescription nasal steroid spray Flonase® (fluticasone). A prescription nasal steroid spray can decrease nasal and sinus inflammation and mucus production. This generally provides a more lasting decrease in sinus pressure and improves sinus drainage. This may lead to a return of your sense of smell. A nasal steroid spray does not provide immediate relief of symptoms. It may require several weeks of routine use to become effective. Flonase® (fluticasone) is often helpful, but doesn’t appear to be helping you. Check with your doctor to see if trying a different nasal steroid spray will give you back your sense of smell.
You are on good treatment. Since your symptoms are continuing, you will need to work with your doctor to find out the nature of your problem. Please read our Sinusitis MedFact at http://www.nationaljewish.org/medfacts/sinus.html for further information. An immunologist would be the type of specialist to identify the best treatment for your CVID. An ENT would be the type of specialist to identify what is causing your sinus symptoms to continue and the best treatment.
Sinusitis is an inflammation, or swelling, of the mucous membranes that line the sinus cavities. This can block sinus drainage and cause increased mucus production. Symptoms can include a headache or pressure in the area of the sinuses, a stuffy nose, achy teeth, postnasal drip, cough, sore throat, laryngitis, constant low fever, and thick, yellow to green nasal drainage.
The most common cause of sinusitis is an infection, especially when the mucus is green. Sinus infections can be difficult to treat since they respond slowly. When a bacterial infection is the cause you may need to take an antibiotic for 2 weeks or longer. Even after the antibiotic clears the infection, it is possible for the inflammation to linger. However, inflammation of the sinuses could also be due to an allergy or chronic exposure to an irritant, such as the smoke from the Mexican fires.
Drainage from the nose and sinuses that drips down the back of the throat is known as postnasal drip. This can fester sinusitis. An antihistamine like Allegra® (fexofenadine) and Zyrtec® (cetirizine) can dry up the postnasal drip. However, it may make the mucus thicker and more difficult for you to blow out of your nose. A decongestant can relieve your blocked sinuses and thin the postnasal drip so it drains better.
Your sinuses can be very important to your sense of smell. When the drainage of your sinuses is blocked, you may lose your sense of smell. Until the blockage is cleared your sense of smell will not return. A nasal wash helps remove mucus and bacteria from the nose and sinuses. This can temporarily reduce the postnasal drip and help your sinuses to drain better. You may have short-term return of your sense of smell, but you may lose it again because the blockage is not completely cleared. Please read our Nasal Wash MedFact at http://www.nationaljewish.org/medfacts/nasal.html for more information about this daily treatment.
Since your sense of smell hasn’t returned, your doctor recommended following the nasal washes regularly with the prescription nasal steroid spray Flonase® (fluticasone). A prescription nasal steroid spray can decrease nasal and sinus inflammation and mucus production. This generally provides a more lasting decrease in sinus pressure and improves sinus drainage. This may lead to a return of your sense of smell. A nasal steroid spray does not provide immediate relief of symptoms. It may require several weeks of routine use to become effective. Flonase® (fluticasone) is often helpful, but doesn’t appear to be helping you. Check with your doctor to see if trying a different nasal steroid spray will give you back your sense of smell.
You are on good treatment. Since your symptoms are continuing, you will need to work with your doctor to find out the nature of your problem. Please read our Sinusitis MedFact at http://www.nationaljewish.org/medfacts/sinus.html for further information. An immunologist would be the type of specialist to identify the best treatment for your CVID. An ENT would be the type of specialist to identify what is causing your sinus symptoms to continue and the best treatment.
