Pages Menu

Column originally published Sep 30, 2014

Allergy And Sinusitis Can Have Serious Complications

Question: Our six-year-old son was recently admitted to the hospital with a bad infection around his right eye; his eyelids were swollen and he couldn’t open his eye. He was treated with several days of IV antibiotics before he started to improve. Our doctor told us that the infection started from his sinuses. All of us have sinus problem, but our son is the worst; he is congested year-round, and he gets worse in spring and fall. Our younger daughter is not much better, and she snores at night. My husband and I are frequently congested, and we get sinus headaches. I have bottles of sinus and congestion medicine in our medicine cabinet. Is there anything that we can do to improve things?


Your son’s eye infection is called peri-orbital cellulitis. It is an infection of tissues around the eye. The bone that separates the sinuses from the eye is very thin in children; as a result, sinus infection (also called sinusitis) can spread easily to the eye. Peri-orbital cellulitis is a serious infection, if it is not properly treated, it can seriously damage vision in the eye.

From what you have described, sinus problem is affecting everyone in your family. This is not uncommon because the underlying cause is allergy. Allergy is a genetic condition passed from one generation to another through our genes.

The most common trigger of allergy indoors include dust mites, animal danders and mould. Dust mites are very tiny insects found in carpets, mattresses, pillows, soft stuffed toys, sofas, and forced-air heating system. They are in most homes to varying degree. Cats, dogs, and other furry indoor animals can trigger allergy in susceptible individuals. Mould can grow indoors in basements and around windows, in places where it is cool and damp.

Outdoor triggers include pollen from trees, shrubs and flowering plants. Moulds are important triggers in early spring when snow melts, as well as in fall in fallen leaves. Mould is nature’s way of breaking down vegetation. Outdoor triggers tend to be seasonal, depending on the kind of triggers that you are allergic to. However, indoor triggers can be year-round, although it can be worse in some parts of the year.

Most allergy sufferers find that their symptoms are worse in fall and winter seasons. This is because we stay indoor much more, exposed to the triggers that I have mentioned here. In addition, viral infections spread around more when children go back to school. When you have a viral infection, there is further swelling of the mucosa, and more mucus is produced. As a result, there is more blockage of the sinuses, leading to more frequent sinus headaches and sinusitis in fall and winter months.

There is very little that you can do to reduce outdoor triggers. If you are sensitive to mould, you should hire someone to rake the leaves. Putting wet laundry on clothesline can trap pollens and mould in the air, which can trigger more allergy symptoms when you bring the laundry indoors.

On the other hand, you can reduce and remove triggers indoor. Removing carpets in the house is probably one of the most effective way of reducing dust mites. Putting zippered plastic covers over mattresses and pillows can reduce dust mite exposure in bed. Stuffed toys are wonderful companions, but they can keep dust mites around and makes it hard to control allergy. You should remove all stuffed toys from your home, not just putting them on shelves or in toy boxes.

In recent years, parents have found that air purifiers with HEPA filters (high-efficiency particulate air filters) placed in children’s bedroom and in living or play rooms can reduce dust mites and other microscopic particles in the air, markedly reduce the severity of allergy symptoms. These units can be expensive, and they should be kept on around the clock, even when the child is not in the house or in the room. They continuously suck air through the HEPA filter and clean the air.

Basements are often cool and damp, ideal for mould to grow. Reducing humidity in basement with dehumidifier can prevent mould from growing there. Watch for moisture on your windows especially in winter. Use a dry towel to remove the water, or adjust the humidity in your ventilation system to reduce indoor moisture.

Allergy to indoor pets can be difficult to manage. Sometimes, it is not easy to know whether you are allergic to them. If you touch a cat and start to sneeze and get congested shortly afterwards, then it is obvious. However, sometimes the symptoms are not as obvious; skin test can be helpful to determine whether you are allergic or not. If you don’t already have pets, stay away from them until everyone is better. If one of you is very allergic to a pet at home, it will be a tough decision. Sometimes, removing the pet is necessary to control allergy symptoms.

You should explore treatment options with your doctor. I don’t recommend using cold and sinus medicine because they have potential side effects, and they are not very effective. Nasal steroid spray is very safe; it can reduce inflammation in the nasal passage and sinuses, reduce mucus production, keep sinus passage open and reduce sinus congestion and headaches, as well as sinusitis. Long-acting antihistamines (like claritin, reactine, etc) can reduce allergy symptoms with little side effect.

Allergy and sinusitis is not as benign as it seems; teach your children to blow the nose in the morning and at night, when they brush their teeth. This can give you an idea how clear their nasal passage and sinuses are. You can monitor their condition and prevent serious sinusitis and its complications.