If either a viral or bacterial infection lasts longer than 4 weeks despite antibiotics, or if you experience at least four consecutive recurrences of acute sinusitis or rhinosinusitis, you may be diagnosed with acute recurrent sinusitis. Many of my patients can effectively treat their acute symptoms within 2 weeks, but as soon as they stop taking their medicines their initial symptoms recur. They are suffering from an acute recurrent form of sinusitis or chronic sinusitis.

This repetitive nature is actually a very common complaint among patients whose previous treatments have failed. These people experience

some temporary relief, but as soon as they stop taking their medicines their condition worsens.

The cause of acute recurrent sinusitis or chronic rhinosinusitis can be one of many factors, including:

■ Treatment with the wrong medicines

■ Anatomical problems that lead to irreversible obstruction, which require surgery

■ Continuous exposure to pollution, fungus, and environmental irritants

* Cigarette smoking or frequent contact with secondhand smoke

■ Noncompliance with medicines and treatment

■ Use of recreational nasal drugs (e. g., sniffing cocaine or glue)

Often, I find that patients get recurrent infections because they may have needed a 3- to 8-week course of medicines or sometimes longer, yet they took the medications only for the first 2 weeks. Or they needed

2 weeks of medicine and only took 7 or 10 days worth. The problem was simply not treated long enough to begin with. The symptoms quelled to the point at which the patients thought that they were better, but in actuality they never got rid of the root of the problem. And when they stopped their medicine, the infection flared again.

Others may be experiencing allergies, which may be a component of their chronic or acute recurrent sinusitis. It’s important for your physician to determine all of the causes of your recurrent problems. It is only when each cause is properly identified that each problem can be addressed and treated appropriately. Very often, though, I find that acute recurrent sinusitis is just chronic sinusitis with recurrent bouts; therefore, the chronic underlying problem needs to be addressed.

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