Is it actually possible to tell the difference between viral and bacterial sinusitis?

[RealLifeClanger]

I got ill on Monday last week. Was rough for a good few days then started to gradually improve. Then on the Saturday I felt worse again. My sinus on the left side is really painful and I'm wondering if it's a bacterial infection. I have a bone spur in my nose on that side and my molars also extend in to my sinus cavity on both sides but my left sinus is always worse with any colds. I don't know if it's even possible to tell whether it's bacterial or not but it's been 9 days now and I'm losing my mind with it. I noticed it got worse after I did a good cleaning of my gums with the little brushes so I'm hoping I've not done something. I've booked in at the dentist tomorrow just in case it's coming from my teeth/gums. But if not then I suppose I'll have to go to the gp. I don't have a noticeably high temperature but do feel pretty awful and have no energy whatsoever. Really have no idea if it's just a horrible illness or something more sinister. I've been using beconase for a couple of days in the hope that will help a bit.

Has anyone actually had a confirmed bacterial sinus infection? How does it compare to viral and what antibiotics did you get?

I had what I thought was sinusitis but turned out to be dental. I've also had actual sinusitis. Both are miserable. I hope you get some answers and feel better soon.

I had a cold for a few days recently that transitioned to very bad sinus pain. The headache was severe and unresponsive to pain relief. I also developed a persistent dry cough. I filled in an online request and My GP saw me same day and prescribed antibiotics on the basis of the headache, facial pain and what he said was a very red and inflamed throat. He also gave me decongestants and a nasal steroid inhaler. The sinus pain cleared as did the cough so I assume there was something bacterial going on. However 2 weeks since the start of the cold and 3 days after finishing the antibiotics I am still ‘virally’ and shattered.

@InvitedWho that sounds nasty. What antibiotics were you given? Was the steroid inhaler a spray?

@amylou8 what was the dental issue? Did your sinus pain clear up once it was treated?

I had doxycycline. They really upset my stomach. Honestly, last week was a write-off. Yes the inhaler was a spray- squirt up each nostril thing, not an asthma inhaler

@InvitedWho I've just had a course of doxycycline and it didn't affect me like that at all, but other types have. Maybe mention it next time you need antibiotics and they can try you on a different one.

@RealLifeClanger All my top teeth hurt whenever I get sinusitis.

@InvitedWho oh no, I really hope to avoid antibiotics as I react badly to so many of them. Hope your stomach settles down soon.

@sherbetlemonade that's reassuring that the doxycycline didn't affect your stomach too much. My teeth on the left side hurt a lot. When you say sinusitis do mean bacterial? My gp says bacterial sinusitis is really rare so they might not give me antibiotics anyway.

@RealLifeClanger My teeth hurt whenever I get any kind of blocked sinuses, and it's not always an infection as I also suffer from perennial rhinitis which blocks me up something rotten.

@RealLifeClanger maybe they’re correct that it’s really rare but I’ve had it quite a
lot including chronically - definitely bacterial every time!

Meant to add: I always have tooth pain with it as well. It can make you so horribly ill and exhausted.
I can’t remember which antibiotics I’ve had (so many different times) but I’m on doxycycline long-term for something else and that’s what finally cleared it up. I take doxycycline twice a day and it’s never caused me stomach issues (thank heavens).

If it helps, you usually don't need a GP to get antibiotics for sinusitis. It's one of the things pharmacists can prescribe now (unless for under 12 years old).

I've had sinus pain with a bad cold and it was quite uncomfortable. Over the counter decongestant and warm, steamy baths helped.

I've had bacterial sinusitis once and, oh my God, it's a different beast entirely.

I had fever, shaking and frankly felt like death. I was spilling my tea from the shaking. Decongestant medicine brought about 5 minutes of relief but that was it. I saw my GP and the moment I walked in the room she said you look like you've got sinusitis. I hadn't even sat down. I'm not sure what she could see but she was right.

I had antibiotics and within 24 hours I started to feel a lot better. I spent the next week snotting out huge quantities of luminous green gunk from my nose. I'd never seen anything like it before and I hope to never experience it again.

I used to work with a GP who said, about Sinusitus, " If you give antibiotics for Sinusitus, it'll clear up in 2 weeks...if you don't, it'll clear up in a fortnight"
I'm really not sure....taking a really clear history, taking time and a considered approach, along with the time trajectory and personal circumstances, would influence my prescribing stance.
Not particularly helpful, though!...

My ENT consultant said its white mucus that shows a bacterial infection, not yellow/green which surprised me, thats when he gives me antibiotics.

I’ve had dreadful sinusitis too for over 2 weeks. I had antibiotics which seemed to help then it came back again. On a TV programme this week a doctor said the only thing which really helps is doing a sinus wash, which I’m going to try. It is so miserable and I am exhausted. My teeth hurt too and my lips are sore and inflamed.

Never take doxycycline on an empty stomach, I had it for a chest infection & made that mistake, I thought I was dying from the burning stomach pain.

I was eventually referred to an ENT and she had me using a Neti pot daily. It didn’t help me - I eventually had an operation - but presumably most people find it helpful!

I had horrific sinusitis about 2 months ago. Awful pain in my face, eye and teeth. So much bright green gunk with blood. And the smell was just awful. It went away with the treatment. But I now have bad chest infection, and now have sinus pain again. Started doxycycline yesterday with steroids too. So fingers crossed.
id say if you think you have an infection in your sinuses. Get treatment asap, because the smell is embarrassing. And the pain at that point is unbearable. My face was swollen up on one side.

Thanks everyone, the responses make me think it isn't bacterial as I have mostly clear snot and while I feel rubbish, I don't have massive swelling or a fever or anything. Beconase is helping a bit now. I think my main issue is my stupid bone spur. I will ask to get referred back to ENT.