Acute Viral Sinusitis, No Antibiotic Treatment (Child)

The sinuses are air-filled spaces in the skull. They are behind the forehead, in the nasal bones and cheeks, and around the eyes. When sinuses are healthy, air moves freely and mucus drains. When a child has a cold or an allergy, the lining of the nose and sinuses can become swollen. This is called sinusitis.

Sinusitis often starts with a cold. Cold symptoms usually go away in 5 or 10 days. If sinusitis develops, though, the symptoms continue and may even get worse. Your child may have pain or swelling in the face, sore throat, headache, or bad breath.

The healthcare provider has determined that your child’s sinusitis is not caused by bacteria. No antibiotics are needed. The provider may prescribe pain medicine, saline drops for the nose, or a decongestant to help ease symptoms. Symptoms usually get better in 2 to 3 days.

Home care

Follow these guidelines when caring for your child at home:

  • You may be told to give your child saline nasal drops or a decongestant. Follow instructions for children when using these medicines.

  • If your child has pain, give him or her pain medicine as advised by your child’s provider. Don't give your child aspirin unless told to do so. Don't give your child any other medicine without first asking your child's healthcare provider. 

  • Give your child plenty of time to rest. Try to make your child as comfortable as possible. Some children may be distracted by quiet activities.

  • Encourage your child to drink liquids. Toddlers or older children may prefer cold drinks, frozen desserts, or ice pops. They may also like warm chicken soup or beverages with lemon and honey. Don't give honey to children younger than 1 year old.

  • Use a cool-mist humidifier in your child’s bedroom to make breathing easier, especially at night or if the air in your house is dry. Clean and dry the humidifier to keep bacteria and mold from growing. Don’t use using a hot water vaporizer. It can cause burns.

  • Don’t smoke around your child. Tobacco smoke can make your child’s symptoms worse.

  • Don't use antihistamines with acute sinusitis. They can keep fluid from draining from the sinuses.

  • Sinus infections are not contagious. Your child may return to school if they don't have a fever and feel up to it.

Follow-up care

Follow up with your child’s healthcare provider, or as directed.

When to seek medical advice

Call your child's healthcare provider right away if your child has any of these:

  • Fever (see Fever and children, below)

  • Fever doesn't improve after starting antibiotics.

  • Swelling or redness around eyes that lasts all day, not just in the morning

  • Vomiting that continues

  • Sensitivity to light

  • Irritability that gets worse

  • Sudden or severe pain in face or head

  • Double vision

  • Not acting right or thinking clearly

  • Stiff neck

  • Breathing problems

  • Symptoms not going away in 10 days

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

  • Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

  • Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

  • Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

  • Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

  • Mouth (oral). Don’t use a thermometer in your child’s mouth until he or she is at least 4 years old.

Use the rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell him or her which type you used.

Below are guidelines to know if your young child has a fever. Your child’s healthcare provider may give you different numbers for your child. Follow your provider’s specific instructions.

Fever readings for a baby under 3 months old:

  • First, ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead: 100.4°F (38°C) or higher

  • Armpit: 99°F (37.2°C) or higher

Fever readings for a child age 3 months to 36 months (3 years):

  • Rectal, forehead, or ear: 102°F (38.9°C) or higher

  • Armpit: 101°F (38.3°C) or higher

Call the healthcare provider in these cases:

  • Repeated temperature of 104°F (40°C) or higher in a child of any age

  • Fever of 100.4° F (38° C) or higher in baby younger than 3 months

  • Fever that lasts more than 24 hours in a child under age 2

  • Fever that lasts for 3 days in a child age 2 or older

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