Subacute sinusitis, the second stage of sinusitis, arises when there is inflammation and swelling in the sinuses for 15 to 45 days. It occurs after the acute sinusitis stage. In this stage, the severity of the symptoms will decrease compared to the acute stage. This gives the patient the wrong idea that the disease is subsiding. But internally, the condition will continue to progress.
Subacute sinusitis is more likely to progress to chronic sinusitis if left untreated. Without medical intervention, there is a higher chance of the infection progressing to the chronic stage rather than being eliminated.
What Causes Subacute Sinusitis?
When acute sinusitis is untreated or only partially treated, it can either resolve itself or move to the subacute stage. Acute sinusitis is the initial stage and is a severe form of sinusitis caused by a viral infection that turns into a bacterial sinus infection. Usually, acute sinusitis lasts only up to 15 days. During these 15 days, if the disease is left untreated or partially treated, the inflammation in the sinuses can persist and progress to subacute sinusitis. A decrease in the severity of the symptoms is observed after 15 days, indicating the switch to the subacute stage. The subacute stage of sinusitis usually lasts from 15 to 45 days of sinusitis.
To know more about sinusitis causes, read our article "What causes sinusitis?".
Subacute Sinusitis Symptoms
Usually, the list of symptoms for sinusitis are the same in all stages. Subacute sinusitis symptoms will be less in number and less in severity when compared to its preceding acute sinusitis stage. In acute sinusitis, we will experience 4 to 5 symptoms with higher severity. Whereas in subacute, we will experience the same or one or two fewer symptoms with lesser severity, and in chronic sinusitis, we will experience 1 to 2 symptoms only with significantly less severity. This is because as the infection persists, but the infection adjusts to our body's immunity establishing a balance between both, resulting in fewer complaints. Patients may mistakenly believe that their disease is decreasing as their symptoms decrease. But in reality, the infection will continue to worsen and can even spread to from one sinus to another and even other parts of the body.
Here is the list of symptoms of sinusitis:
Nasal discharge or a runny nose
Nasal congestion or a stuffy nose
Headaches
Facial pain
A sensation of phlegm dripping from the back of the nose to the throat
the need to frequently clear the throat
Sore throat and throat pain that occur often
Frequent bouts of coughing
Diagnosis for Subacute Sinusitis
Subacute sinusitis is diagnosed by the doctor using your symptoms and medical history. They may also use a nasal endoscopy to look for signs of inflammation in the nasal passages and sinuses. This can include things like nasal polyps, mucoid discharge, or pus.
If standard medications fail to improve your symptoms, your doctor may suggest a CT scan. This scan can provide detailed images of your sinuses, allowing your doctor to determine which sinuses are affected and the severity of the infection in each sinus.
Usually, subacute sinusitis is diagnosed with a nasal endoscopy. However, a CT scan may be needed if your symptoms don't improve or if there are complications.
To learn more about diagnosis, read our article "Sinusitis Diagnosis - How to Identify Sinusitis?"
Treatment Options for Subacute Sinusitis
As said earlier, the chances of subacute sinusitis turning into chronic sinusitis are always higher. So it is crucial to consult a doctor for a proper diagnosis and treatment plan for subacute sinusitis. The treatment may vary depending on the underlying cause and severity of the condition. Usually, the standard treatment for subacute sinusitis involves treating it with antibiotics and minor surgery if necessary. The treatment for subacute sinusitis is similar to acute sinusitis. The only difference is that the treatment will be slightly aggressive in subacute when compared to acute.
Antibiotics and Other Medications
In subacute sinusitis, the bacteria present are gram-positive bacteria. So we treat subacute sinusitis with antibiotics that act on gram-positive bacteria for at least 15 days. Along with antibiotics, we also use other supportive medications like antiallergic medications in case of allergies, and decongestants like xylometazoline and oxymetazoline - otrivin nasal drops are also essential.
The antibiotics that act on gram-positive bacteria will cause disturbance in the bacterial flora in our intestines, leading to diarrhea and loose stools. So to address this issue, doctors may prescribe lactobacillus, which can aid in the recovery of the lost flora in the intestines.
Surgery
In most cases of subacute sinusitis, surgery is not necessary. However, doctors may recommend a CT scan if they suspect complications in the sinuses. Suppose only one or two sinuses are stalling the healing process and are not responding to antibiotics. In that case, the ENT doctor may suggest minor surgery to drain the infected sinuses and remove blockages. The remaining sinuses will continue to be treated with antibiotics. This targeted surgery approach helps to avoid unnecessary bigger sinus surgery and promotes faster recovery. In contrast, in chronic sinusitis, where surgery is done on all the (around 40) sinuses, in subacute sinusitis, surgery is done only on the affected sinus.
Thankfully as per Dr. K. R. Meghanadh, he does only one or two surgeries for subacute sinusitis. So, the chances of recovery with antibiotics are higher in this stage when compared to chronic.
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