A sinus infection can be a miserable experience—painful pressure in the face, headache, body aches, postnasal drip, fever, and congestion. But is a sinus infection bacterial or viral? It actually can be either—or both! The symptoms for viral and bacterial sinus infections can be similar, but the treatments may be different. Let’s take a closer look at how you might be able to tell them apart, and what you can do for treatment.


The sinuses are spaces in the bones of the face, located around the eyes, in the forehead and cheekbones, and behind the nose. Their primary function is to produce mucus, moisturizing the nose and protecting both the nose and sinuses from germs, dirt, dust and other irritants. When everything is working as it should, this mucus drains freely from the nose and sinuses. A sinus infection, or sinusitis, occurs when there is inflammation of the sinuses. The mucus becomes thick and unable to flow into the nose, causing build-up in the sinuses themselves.


Most sinus infections are viral, but viral sinusitis can develop into a secondary bacterial infection when bacteria becomes trapped in the sinuses and colonizes due to inflammation preventing proper drainage. Many different types of bacteria can cause sinusitis. Some of the most common bacterial culprits for sinus infections include:

●    Streptococcus pneumonia,

●    Streptococcus pyogenes,

●    Haemophilius influenzae,

●    Pneumococcus,

●    Moraxella catarrhalis, and

●    Staphylococcus aureus.

How Long Does a Sinus Infection Last and Is A Sinus Infection Bacterial?

Unlike a cold, which typically resolves in five to 10 days, a sinus infection can last four weeks or longer. Sinusitis may be acute (lasting anywhere from three to five days, up to 12 weeks), chronic (lasting longer than 12 weeks), or recurrent (a cycle of recurring sinus infection episodes, up to 12 a year). Since the symptoms of a sinus infection—whether it’s bacterial or viral—can be similar to those of a cold, the longer duration of the symptoms is generally the easiest way to know it’s sinusitis.

Types of  Viral Sinus Infection

A viral sinus infection is most often caused by a common cold, which can infect the lining of the ear, nose, and throat, and inflame the sinuses. There are more than a hundred different viruses that cause colds, the most common of which are rhinoviruses. Some other viruses that can cause sinus infections can include influenza viruses and parainfluenza viruses. Viruses, especially cold viruses, can change the mucus in the nose and cause nasal tissues to swell, blocking the sinuses.

How to Distinguish Between Viral and Bacterial Sinusitis

Viral and bacterial sinus infections may be very similar symptomatically, and a sinus infection that begins as viral can develop into bacterial sinusitis. Much of the time, you can determine if a sinus infection is bacterial, by answering the below questions:

●    Has the sinus infection lasted for 10 or more days, without any improvement?

●    For the first three to four days of the infection, did you experience postnasal drip, face tenderness, and a high fever (102°F or more)?

●    After a cold which lasts five to six days and seems to get better, do symptoms start to get worse, with new face pain or headache, fever, and worsening postnasal drip or stuffiness?

If the answer is yes to one or more of these questions—your sinus infection may be bacterial.

Diagnosis and Treatment Options for Sinus Infection

Sinus Infection Diagnosis

If you have sinus infection symptoms that last more than a week, it’s a good idea to contact a doctor for a proper diagnosis and to find out your treatment options. A physician can generally diagnose a typical or mild case of acute sinusitis with a simple office exam.

For chronic or recurrent sinus problems, there are several options to help with diagnosis. Los Angeles’ leading sinus surgeon, Dr. Alen Cohen, performs minimally-invasive sinus and nasal endoscopy for patients with recurrent or chronic sinus issues. This is an in-office procedure that allows the doctor a closer look inside the nose and sinus openings, to better diagnose the cause of sinus problems. In severe cases of sinusitis, in which an infection isn’t responding to regular treatment, a sinus culture may be considered. This can help determine if a resistant bacteria or fungus is causing a sinus infection. An in-office sinus CT scan can also help determine root causes of sinus problems, by providing detailed 3D images of the sinuses and sinus pathways, allowing the doctor to determine the best course of treatment.

Sinus Infection Treatment

Typically, the key to resolving an acute sinus infection is to restore proper drainage. If you have a sinus infection, here are some treatment steps you can take at home:

●    Stay hydrated,

●    Inhale steam,

●    Use saline nasal spray,

●    Use OTC decongestants and pain relievers.

If your doctor believes you have bacterial sinusitis, you may be prescribed antibiotic treatment. Antibiotic therapy may be appropriate and effective for some bacterial sinus infections, but will not be effective in viral sinusitis.

For chronic and recurrent sinusitis, treatments are available to provide long-term relief. For many people, minimally invasive balloon sinuplasty can be a great cure for ongoing sinus problems. Other people may find relief through minimally-invasive endoscopic sinus surgery, turbinate reduction, or deviated septum repair.

If you’re experiencing persistent sinusitis, schedule a consultation with us today.