‘Tis the season: Allergies vs. Sinus Infections vs. Colds

‘Tis the season for pollen, mold, and trees. Yesterday in clinic, I think half of my 20 visits involved complaints of “I think I have a sinus infection”. The answer to my “Why?” included many common truths and misconceptions, ranging from “because I’ve congested for a week” and “because I have green and yellow mucus” to “because this happens every year to me”. The truth is all of these signs of symptoms may be present, but I’d bet money that patients are correct less than 30% of the time when trying to self diagnose themselves with infection versus inflammation. Would you know the difference?

Let’s first review the common cold, which I’ve talked about many times before. A cold is a viral infection, which means there’s no great cure. There are ways we can shorten the duration of symptoms, but if I had the cure to a cold, I’d be a retired millionaire. If you read a medical textbook, it would say symptoms of a cold include, headache, muscle aches, low‐grade fever, runny nose, and cough, which can last for about a week. By day number 7, symptoms generally begin to dissipate. Because it’s a viral infection, antibiotics are not the treatment. Let me repeat myself—antibiotics do not treat colds. I can imagine what the next question might be after the last statement, and the answer is that you’re right. Doctors do and might prescribe an antibiotic when you present with a “cold”. However, this is incorrect and should not be done. This helps to produce super‐bacteria that are resistant to the drugs we currently have and create monsters, such as MRSA or methicillin‐resistant Staph aureus and other resistant bugs. This means it will be harder to treat you if and when you do have a bacterial infection in the future.

I hear the mumblings of the next question—then why do antibiotics seem to work when taken for a “cold”. I put cold in quotes on purpose, because what patients often think is a cold isn’t really a cold. It may be a bacterial sinus infection, walking pneumonia, or Strep throat. Or, what I believe is the most common reason, is that the cold was going away on its own, and it was coincidental that you were taking the antibiotic at the same time. In other words, it probably would have gone away without you doing anything. You just happened to be taking an antibiotic at the time.

What does help and what has been proven in studies to help includes, taking Zinc (such as Zicam) or eating chicken noodle soup at the first start of symptoms to cut your sick time by 2 days. Notice I didn’t say cure but shorten the amount of time you’re sick. After trying to shorter the duration of the cold, we treat the individual symptoms with antihistamines, cough medicine, menthol, tea, salt water gargling.

During the allergy season, it becomes even harder to differentiate, because symptoms are similar. Classic allergy symptoms include sneezing, runny nose, itchy, red eyes, congestion, and headache. Allergies don’t occur with fever and are treated with antihistamines, such as Zyrtec or Claritin. Other important treatments include steam, nasal saline and washes (such as Neti pot or saline spray), and cleaning one’s filters in the house and car. A chronic cough can be caused by allergies.

Another million‐dollar question is “Does green mucus mean I have an infection?”

Yes and no. It could mean an infection, but it doesn’t mean it’s bacterial. It is a sign of white blood cells fighting something, and that something could be an allergy or a virus. A bacterial sinus infection is when one‐sided facial pain, runny nose, fatigue,

congestion, tooth pain, and sneezing begin and is prolonged. Talk to your doctor about concerning symptoms.

Be healthy and be blessed,

Dr. Swiner

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