When to Seek Medical Care

Call a doctor when experiencing pain or pressure in the upper face accompanied by nasal congestion or discharge, postnasal drip, or ongoing bad breath unrelated to dental problems.

Fever can be a symptom of a sinus infection or a cold. Simple congestion with a low-grade fever probably indicates a cold and may not call for medications or antibiotics. Those also experiencing facial pain or headaches may have a sinus infection.

A doctor often can treat simple sinusitis. If left undiagnosed and untreated complications of sinusitis can occur that may lead to severe medical problems and possibly death. The following complications are medical emergencies and require immediate treatment in a hospital's emergency department:

• Headache, fever, and soft tissue swelling over the frontal sinus may indicate an infection of the frontal bone, called Pott's puffy tumor or osteomyelitis. Usually, this complication is limited to children.

• Infection of the eye socket may result from ethmoid sinusitis. The eyelid may swell and become droopy. Fever and severe illness are usually present. A person with this infection may lose the ability to move the eye, and permanent-- blindness may result.

• Ethmoid or frontal sinusitis may also cause the formation of a blood clot in the sinus area around the front and top of the face. Symptoms may be similar to those of eye socket infection with the addition of a fixed and dilated pupil. This condition usually affects both sides of the face.

• If a person experiences mild personality changes, headache, neck stiffness, high fever, altered consciousness, visual problems, or seizures, infection may have spread to the brain. Coma and even death may follow.