Sinus infection in Puerto Rico: symptoms, treatment and video visits

Sinus infection symptoms

Acute sinusitis often follows a cold that doesn’t get better, or gets worse, after 7 to 10 days. The most common symptoms are:

• Stuffy or runny nose
• Pain or pressure in the face, behind the eyes or in the upper teeth
• Headache
• Mucus dripping down the throat and a sore throat
• Cough, often worse at night
• Bad breath or loss of smell
• Tiredness and sometimes fever

Viral or bacterial? Why most sinus infections don’t need antibiotics

Most sinus infections are caused by the same viruses that cause colds, and they clear up on their own. Green or yellow mucus does not by itself mean the infection is bacterial or that you need an antibiotic.

The CDC advises seeing a clinician if you have severe symptoms (bad headache or facial pain), symptoms that get worse after improving, symptoms lasting more than 10 days without improving, or fever lasting more than 3 to 4 days. Those patterns make a bacterial infection more likely.

When an antibiotic isn’t needed, it doesn’t help and can cause side effects, allergic reactions, antibiotic resistance, or a C. difficile gut infection. Read more about antibiotics by telehealth.

What happens in the video visit

The doctor will ask how long you have had symptoms, whether they improved and then got worse, whether you have fever, facial pain or headache, allergies or asthma, and what you have already taken. She may ask you to show your face and the area around your eyes on camera.

She will then tell you whether this is most likely a viral sinus infection, treated with home care, or whether you meet the criteria for an antibiotic. Sometimes "watchful waiting" is used: watching for 2 to 3 days before starting an antibiotic. If appropriate, the doctor can prescribe medication. We do not prescribe controlled substances.

An online doctor visit costs US$79 and is for patients who are physically in Puerto Rico during the video call. A prescription, if the doctor considers it appropriate, has no extra charge; see pricing.

Sinus infection treatment and home care

These steps ease congestion and pain while your body fights the infection:

• Put a warm, moist washcloth on your face several times a day.
• Drink plenty of fluids to thin the mucus.
• Breathe in steam, for example in the bathroom with a hot shower running.
• Use saline (salt water) nasal sprays or rinses.
• Decongestant nasal sprays may help at first, but using them for more than 3 days can make congestion worse.
• For pain, acetaminophen or ibuprofen as directed on the label or by your doctor.

Sinus infections in children

In children, a bacterial sinus infection is more likely when cold symptoms (runny nose, daytime cough) last more than 10 days without improving, when fever and thick nasal discharge last 3 or 4 days, or when a child gets better and then worse again. An ordinary cold usually lasts about 7 days.

Saline drops and a cool-mist humidifier help a stuffy nose. Never give aspirin to a child. Over-the-counter cough and cold medicines are not recommended under age 4.

Get care right away if your child has swelling or redness around the eyes that lasts all day, a severe headache or pain at the back of the neck, persistent vomiting, strong sensitivity to light, or is becoming more and more irritable. A baby under 3 months with a temperature of 100.4 °F (38 °C) or higher needs medical care right away. We see children from 6 months old with a parent or legal guardian on camera, and the doctor is not a pediatrician; see video visits for children.

Allergies or a sinus infection?

Allergies and sinus infections overlap, but allergies usually cause itchy nose and eyes, sneezing and clear mucus, with no fever, and flare when you are around your trigger. Poorly controlled allergies can lead to sinus infections. If your symptoms come back in certain seasons or places, see allergies and allergic rhinitis.

When to be seen in person or by a specialist

Complications are rare, but a sinus infection can spread to the eye or the brain. Get in-person care if:

• You have swelling or redness around the eye, or any change in vision.
• You have a severe headache that pain relievers don’t help, or a stiff neck.
• You are confused or very unwell.
• You still have symptoms after finishing an antibiotic.
• You have more than 2 or 3 sinus infections a year, or symptoms lasting more than 12 weeks: you may need an ear, nose and throat or allergy specialist.

Preventing sinus infections in Puerto Rico

Wash your hands often, get recommended vaccines (including a yearly flu shot), avoid tobacco smoke and keep allergies under control. If you use a humidifier, clean it as the maker directs.

Puerto Rico’s humidity matters: mold grows wherever there is moisture, leaks or flooding, and it can cause congestion and cough in sensitive people. Keeping your home dry helps if you have allergies or repeated sinus infections.

Frequently asked questions

How long does a sinus infection last?

Acute sinusitis lasts less than 4 weeks, and most viral cases improve in 7 to 10 days. If symptoms last more than 10 days without improving, or get better and then worse, get checked.

When do I need an antibiotic for a sinus infection?

Only if the evaluation points to a bacterial infection: symptoms lasting more than 10 days without improvement, severe symptoms with high fever, or getting worse after improving. Green mucus alone is not a reason for an antibiotic.

Can I be treated for a sinus infection by video in Puerto Rico?

Yes, in most uncomplicated cases, as long as you are physically in Puerto Rico during the visit. If appropriate, the doctor can prescribe medication. Swelling around the eye, vision changes or a very severe headache need in-person care.

Related pages

• Online doctor visit
• Allergies (allergic rhinitis)
• Sore throat
• Flu (influenza)
• Antibiotics by telehealth
• Online doctor for kids
• Emergencies
• Pricing