Q: Members of my family are chronic allergy sufferers, but sometimes it is hard to tell when it has become a sinus infection or something more. When is it more than just allergies?
A: This is a very common question that we get in our clinic daily. Many illnesses, whether they are allergy mediated or caused by an infection, exhibit similar symptoms. However, the time course and severity of symptoms can differ.
Allergy symptoms, or allergic rhinitis, are most often caused by environmental factors, such as indoor or outdoor allergens. These are very common in our area, especially different pollens and weeds. Allergic rhinitis usually presents after being exposed to these allergens at certain times of the year (spring and fall). Allergic rhinitis presents with itchy watery eyes, runny nose, dry cough and even headache and fatigue. However, these symptoms can be successfully treated with over-the-counter antihistamines and intranasal steroids.
Sinusitis (more commonly known as a sinus infection) may present in a very similar way, but symptoms also may include fever, facial and head pain worse on one side, sinus pressure and changes in taste or hearing.
Important differences to keep in mind are time course and severity of symptoms. Allergies typically improve with antihistamines or steroids and can improve if outdoor/indoor allergens are no longer present. Sinusitis often requires antibiotics, and symptoms are often severe, lasting weeks, even with proper treatment. One good rule of thumb is that if you have been experiencing symptoms for a week, not improved with over-the-counter medications, you should see your doctor to rule out other types of infection.
— Dr. Greg May, Family Medicine at UT Erlanger Primary Care – Lookout Mountain; member, Chattanooga-Hamilton County Medical Society