From the Guidelines
Yellow mucus from the nose is not a definitive indicator of sinusitis cure, but rather a sign of inflammation and infection in the sinuses. According to the study by 1, nasal purulence alone does not indicate a bacterial infection, and discolored nasal discharge is a sign of inflammation, not specific for infection. The coloration of nasal discharge is related to the presence of neutrophils, not bacteria.
Symptoms of Sinusitis
- Nasal congestion
- Purulent rhinorrhea
- Postnasal drainage
- Facial or dental pain
- Headache
- Cough
- Fever
- Nausea
- Malaise
- Irritability
- Fatigue
- Halitosis
- Hyposmia
- Sore throat
Treatment of Sinusitis
- Saline nasal irrigation (using a neti pot or saline spray) 2-3 times daily to flush out mucus
- Over-the-counter decongestants like pseudoephedrine to reduce congestion for up to 3 days
- Intranasal corticosteroids such as fluticasone (Flonase) or mometasone (Nasonex) used once or twice daily to reduce inflammation
- Analgesics or antipyretic drugs (acetaminophen, ibuprofen, or other nonsteroidal anti-inflammatory agents) for pain or fever
- Topical intranasal steroids may have a role in managing viral rhinosinusitis, even though they do not have a Food and Drug Administration (FDA) indication for this purpose, as stated in the study by 1.
When to Seek Medical Attention
If symptoms persist beyond 10 days, worsen after initial improvement, or include high fever, severe pain, or vision changes, it is essential to seek medical attention as antibiotics may be needed, as suggested by the study by 1. Staying hydrated and using a humidifier can also help thin mucus and improve drainage.
From the Research
Symptoms of Sinusitis
- Yellow mucus repeatedly coming out of the nose can be a symptom of sinusitis, but it is not a definitive sign of cure 2, 3, 4.
- Other symptoms of sinusitis include nasal congestion, rhinorrhoea, facial pain, hyposmia, sneezing, and malaise 3, 4.
- The presence of purulent nasal discharge with obstruction of the nasal passages is a cardinal feature of acute bacterial rhinosinusitis 2.
Treatment and Cure
- Antibiotics may be considered for patients with severe symptoms, significant worsening after 3 to 5 days of symptoms, or 7 or more days of symptoms 2.
- Supportive care, including saline irrigation, nasal steroids or antihistamines, and decongestants, may help reduce the severity of symptoms 2, 3, 4.
- Most episodes of rhinosinusitis are self-limited, lasting 7 to 10 days, but complications can occur, such as orbital cellulitis, meningitis, and abscess 2.
Diagnosis
- Sinusitis is a clinical diagnosis, and distinguishing between bacterial and viral sinusitis can be challenging 2.
- Diagnostic testing for acute rhinosinusitis with antral puncture is impractical due to its invasiveness, and point-of-care testing for elevated C-reactive protein may be helpful but is not widely available 2.
- Computed tomography and referral to an otolaryngologist should be considered for patients with recurrent rhinosinusitis or concern about complications 2.