Tricky childhood symptoms of sinus infection

No, it's not a headache, stuffy nose, or even green mucus -- though these can accompany an infection of the sinuses.  The most common symptoms of a sinus infection in a child are a wet, mucusy cough, often along with vomiting of mucus.  While these can happen with a garden-variety "cold", or viral respiratory infection, symptoms will generally linger much longer when there is a true bacterial sinus infection present.  Be sure to check with your child's doctor if these symptoms continue beyond 7-10 days with no sign of improvement.

If your child has asthma, keep in mind that a sinus infection can trigger an asthma flare-up, and may require earlier diagnosis and treatment. 

Can asthma be prevented?

Recent studies would suggest that by reducing a child's exposure to allergy triggers, not only are you helping get rid of annoying nasal symptoms like a stuffy, runny, itchy nose, but you may be preventing the development of asthma. 

Researchers describe the progression of symptoms from skin allergies (eczema) in babies to nasal allergies in toddlers and kindergarteners (allergic rhinitis) to asthma in older children as "the atopic march".  This tends to happen when there is continuing exposure to things that the child is allergic to, such as dust mites or pollens.  The better the environmental control of these allergens, the less likely symptoms will progress to more severe conditions such as asthma.

Childhood Asthma and Reflux

Esophageal acid reflux can trigger asthma at any age.  A study recently published in the in the Journal of Asthma suggested that children with higher intensity acid reflux (with abnormal results on esophageal pH monitoring) had more frequent or difficult-to-control nighttime asthma attacks.

It is important to consider GERD, or gastroesophageal reflux, in young children with asthma whose nighttime asthma control is difficult, especially if they are found to have no underlying allergies triggering their asthma.   The age of onset of nighttime uncontrollable asthma was younger for children with abnormal pH results:  3.63 vs. 5.77 years.

This study raises the possibility that some asthmatic children may have coexisting GERD in need of treatment.

Kwiecien J, Nachura E, Halkiewicz F, et al: Clinical features of asthma in children differ with regard to the intensity of distal gastroesophageal acid reflux.  J Asthma. 2011; 48: 366-373.