Written by: Pamela Eliowitz, Registered Nurse at UCSD Medical Center

Websites:
http://www.viralnurse.blogspot.com
http://www.viralnurse.com

What it is “Staphylococcus Aureus:”

Staphylococcus aureus and Staphylococcal Disease is gram positive sphere shaped bacteria. Bacteriological culture of the nose and skin of normal humans is positive for staphylococci. An infectious process is when a disruption occurs that affects the normal host defenses inside the sinuses; those defenses may allow bacteria, which are normally present in the nasal passages, to enter any of the sinuses. Once there, the bacteria may stick to the cells lining these cavities and cause a sinus infection. The sinuses are covered in a mucus layer and a host of ciliary hairs that helps to trap and remove pathogens before they become a serious problem.

As noted in WebMD
“Ostiomeatal complex (OMC) connects the nasal passage to the paranasal sinuses. A viral infection (there are over 300 cold viruses) causes damage to the cells of the sinus lining. This damage leads to inflammation. The lining thickens with fluid that obstructs the nasal passage. This passage connects to the sinuses. The obstruction disrupts the process that removes bacteria normally present in the nasal passages, and the bacteria begin to multiply and invade the lining of the sinuses. This causes sinus infection symptoms. Allergens and pollutants produce a similar effect. Bacteria that normally cause acute sinusitis are Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. These microorganisms, along with Staphylococcus aureus and anaerobes (bacteria that live without oxygen), are involved in chronic sinusitis.”

Keep the Red Out:

What you want to aim for if you have been diagnosed with a Sinus infection is to reduce inflammation; this is a critical step for improving your symptoms, and reducing your risks of further inflammation, damage to your sinus cavities, and secondary infectious processes. Your Eustachian tubes can be involved in the inflammatory process as well, by sending the infectious material into the Eustachian tubes when blowing your nose, hard enough and too frequently, can cause this to happen. Then you have to worry about ear infections, and that is no fun; it opens a whole other “can of worms.”

Keep it moving:

Promoting drainage, you want to encourage. They mention different treatments you can do at home to help the drainage. I myself went to an ENT surgeon a few years ago, because I was having chronic sinus infections that kept turning into pneumonia. The Surgeon took a lighted scope and entered through one of my nostrils and examined the entire area. Then after a few minutes of probing around the sinus cavities, he pulled it out and said he would be right back, and he left the room. When he returned, he had a box in his hands. A Nasal Saline Kit, but there are others that are recommended by top surgeons for instance: The Grossan Hydro Pulse Nasal/Sinus Irrigation System, is like a waterpik: a number to reach them: (800) 560-9007. Another one SinuPulse. Ethicare: (800) 253-3599; and the Netipot, is one most people seem to use.

I think it is a matter of choice and convenience. I prefer using the Neilmed Sinus Rinse Starter Kit, it comes with packets of sodium chloride and sodium bicarbonate mixture, and directions for use. I use it twice a day when I’m feeling stuffy, and then up to three times per day when I’m sick with a cold or sinus infection. It has made a huge difference in my life. For one, I don’t suffer with Sinus infections like I did before using the irrigation kit, and therefore, I do not suffer from having pneumonia and prolonged illness related to sinus infections; not having use antibiotics, or at least thus far. I did have an ear infection, which was caused by chronic swimmers ear. Some patients will be told to irrigate with an antibiotic that the physician will prescribe if you have an active sinus infection and you are a person that gets them chronically, and have a history of bacterial resistance.

Quoted by: Dr. Mirkin.com http://www.drmirkin.com/morehealth/G167.htm

“Most of the time, you can clear staph aureus from your nose by applying a bacitracin, mupiricin or combination antibiotic ointment in your nose at bedtime for several weeks. You can buy inexpensive bacitracin ointment without a prescription and apply a small amount inside your nostrils for several weeks. Many doctors prescribe the far more expensive prescription ointment, mupiricin, because of the intense publicity that has been generated for its use. Some people have had to apply an antibiotic ointment into their noses for five days each month for one year to be cured. If you have a resistant staph aureus, cultures will tell you what antibiotic to use. Sometimes, you may need to use intravenous vancomycin inside your sinuses.” “Aspirin and Motrin reduce the symptoms of being sick but may reduce your own immune system’s ability to fight the cold.” By: Terence M. Davidson, M.D., F.A.C.S” Handbook of Nasal Disease”

As quoted in Ambulatory Healthcare Pathways for Ear, Nose, and Throat Disorders, from UCSD Medical Center (p3):

“…Antihistamines concentrate and increase the viscosity of nasal mucus and impair mucociliary clearance. They are therefore counterproductive.”

That is why it behooves you to discuss a plan of care with your healthcare provider, because not all sinus infections are going to be treated the same. Also, in severe cases a CT scan will be ordered to rule out sinus infection, as there are many other causes with the same symptomology. Your doctor will want to have conclusive results. This way he will know how serious the invasion is and what treatment options, from the least invasive to the most invasive, and that can mean emergent surgery.

How to distinguish between Allergy and Infection:

If it’s an allergy, a reaction to an allergen these are the symptoms you might experience,they include: Itchy water eyes, or just feeling itchy, and sneezing.

If you have an infection, your symptoms are going to be, nasal blockage, nasal congestion, post nasal drip, coughing, facial pain, fever, and body aches.

Complications:

The infection, if left untreated or if it is so resistant to antibiotic treatment, it can then turn into a medical emergency. The bacteria can travel into the your brain via penetration of the sinus wall, within the orbit, and then into the central nervous system; this is when you hear about bacterial meningitis, caused by direct penetration of the sinus wall in sphenoid sinusitis. Meningitis is a bacterial infection of the meninges in the brain, they are caused by a variety of bugs, but this one that we are discussing today is a major player.

Quoted in: Fulminant Bacterial Meningitis Complicating Sphenoid Sinusitis Akihiko Saitoh, MD, Bernard Beall, PhD,y and Victor Nizet, MD

“…The most common organisms identified in sphenoid Sinusitis are Staphylococcus aureus, S. pneumoniae, and other Aerobic or anaerobic streptococci.3,11 S. pneumoniae appears to be the pathogen most frequently associated with development of meningitis as a complication.” This is why it is so important to see your healthcare provider when you have a sinus infection, and when it becomes a chronic sinus infection. There is a multitude of modalities that are being employed to keep you from making that 911 call.

Quoted in: The UC San Diego Health Sciences Magazine Fall 2008.

“UC San Diego physician-scientists, marine chemists, cell biologists, and pharmacologists are using novel approaches to develop new therapeutic approaches for Staph and Strep infections, particularly those strains that have learned to evade treatment. One of the most promising chemical compounds they have identified has shown initial effectiveness against MRSA and is undergoing extensive testing by Nizet. The potential of the sea is amazing. “In a drop of mud the size of a sugar cube, there are one billion one-celled creatures, any one of which could contain a novel compound with the potential to combat diseases,” Fenical notes.”

As you can see from this article, there are many problems that can evolve from a sinus infection. Not all sinus infections are the same, but they can lead to serious complications and call for emergency treatment. There are certainly enough case studies to prove that there is a need for improved treatments to prevent antibiotic resistance, and modalities that can be employed now, to help prevent the recurrence. Remember to discuss with you healthcare provider all your treatment options.