Locations:
Search IconSearch

Killer Sinus Infection? How to Tell If Yours Is Viral or Bacterial

Some things you can do to ease symptoms

woman with sinus pain

Nasal congestion and swelling, facial pressure, pain, fever, too much mucus. Ugh. It’s probably another sinus infection. Or is it? And is your infection caused by a virus or bacteria — and does it really matter?

Advertisement

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

It does, says otolaryngologist Raj Sindwani, MD. Doctors treat viral and bacterial sinus infections very differently. Here’s what you need to know about both kinds of infections and how to treat them.

Viral or bacterial?

Sinusitis happens when your sinuses — the normally air-filled pockets in your face — become inflamed and blocked. Most sinus infections are viral. How can you tell whether your infection is viral or bacterial based on your symptoms?

“You can’t,” says Dr. Sindwani.

“Symptoms like bad breath, yellow or green mucus, fever and headache are not reliable signs of a bacterial infection,” he says. “They can occur with viral infections, too. Even your doctor can’t tell if your infection is viral or bacterial based solely on symptoms or an exam.”

Instead, your doctor looks largely at symptom duration to determine the source of your infection. A viral sinus infection will usually start to improve after five to seven days. A bacterial sinus infection will often persist for seven to 10 days or longer, and may actually worsen after seven days.

Some steps you can take

Whether your sinus infection turns out to be viral or bacterial, you can help to ease your symptoms early on with supportive sinus care:

  1. Use saline spray two to three times per day in each nostril.
  2. Use a nasal decongestant such as Afrin®, but not longer than three days.
  3. Drink eight 8-ounce glasses of fluid per day.
  4. Get plenty of rest.
  5. Take an over-the-counter anti-inflammatory, like ibuprofen, to help relieve the swelling of your sinuses.

Advertisement

If your symptoms aren’t improving after one week, it’s important to see your doctor. If a bacterial infection is suspected, you’ll probably need to take an antibiotic to clear up the infection and prevent further complications.

“If your infections occur more frequently, and your doctor really wants to establish if they are bacterial or viral, your Otolaryngologist or ear, nose and throat doctor can sample the snot from your nose when you’re infected and send it to a laboratory to know for sure.

Note: Antibiotics won’t help a viral infection, and taking an antibiotic unnecessarily can do more harm than good. You risk possible side effects and increase your chances of developing antibiotic resistance, which can make future infections harder to treat, says Dr. Sindwani. So it’s important to wait and see how long your symptoms last.

What to do for chronic sinusitis

If you’re suffering from chronic sinusitis (nasal congestion, drainage, facial pain/pressure, and a decreased sense of smell lasting 12 weeks or longer) or you are getting frequent sinus infections you should see your doctor, says Dr. Sindwani.

Your doctor will swab your nose to collect mucus. Culturing it in a laboratory will reveal which type of bacteria is causing the infection so the right antibiotic can be prescribed.

Treat early sinus infection symptoms with rest, hydration and over-the-counter sprays and decongestants. But don’t look for an antibiotic unless your illness extends beyond a week, he says. Then check in with your doctor for a prescription and let him or her know if your condition worsens.

Advertisement

Learn more about our editorial process.

Related Articles

female with fingers pressing on bridge of nose in distress
Got a Sinus Infection That Won’t Quit? When To Worry

Give it seven to 10 days, but if your symptoms linger or get worse, it’s time to see a healthcare provider

person getting a sinus massage between brows
5 Sinus Massage Techniques To Relieve Pressure and Promote Drainage

A gentle touch in all the right places may help drain your sinuses

Person reclining on couch using nasel spray to alleviate pressure in sinuses.
January 12, 2023/Ear, Nose & Throat
Relieve Sinus Congestion and Pressure at Home

From nasal sprays to neti pots, these home remedies can help relieve your symptoms

woman in bed wtih sinus problems
February 2, 2021/Ear, Nose & Throat
How Sinus Problems Can Affect Your Sex Life — and What to Do About It

There's hope for chronic nasal and sinus problems that don't put you in the mood

woman suffering from sinus pressure
June 30, 2020/Allergies
6 Steps to Take to Stop Suffering From Sinusitis

How to deal with this common condition

Healthcare provider using tongue depressor to examine patient's throat
March 21, 2025/Ear, Nose & Throat
Why Do You Lose Your Voice? And How To Fix It

Upper respiratory infections, seasonal allergies, excessive use or talking too loudly can make it difficult to speak

Boy holding nostril from a nosebleed outside in the snow
March 13, 2025/Ear, Nose & Throat
How To Stop a Nosebleed

Staying calm, sitting up straight and gently pinching the sides of your nostrils can help a bloody nose go away faster

Person in sweater and knit hat facing window, with winter, snowy yard outside
February 3, 2025/Primary Care
Dry Air Can Negatively Impact Your Health — Here’s What To Do About It

Investing in a humidifier and keeping yourself hydrated can help you stay healthy despite dry air

Trending Topics

Person in bed sleeping on their side, covers off
Breathing Problems? Try These Sleep Positions

If you’re feeling short of breath, sleep can be tough — propping yourself up or sleeping on your side may help

A couple looking at skyline, with one person slightly behind the other, head bent down
What Is Anxious Attachment Style — and Do You Have It?

If you fear the unknown or find yourself needing reassurance often, you may identify with this attachment style

Glasses and bottle of yellow-colored prebiotic soda, with mint, lemon and ginger garnish
Are Prebiotic Sodas Good for You?

If you’re looking to boost your gut health, it’s better to get fiber from whole foods

Ad