Sinusitis – HIV Associated Sinus Problems

 According to medical reports researched for this Article, nasal and par nasal sinus problems are among the most common presentations of HIV disease. Although the percentage of patients with symptoms specifically localized to the nose and par nasal sinuses is not known precisely, prospective studies of patients infected with HIV described a 30 to 68% prevalence of sinusitis.


Nasal stuffiness, a common symptom during HIV infection, has a wide-ranging differential diagnosis that includes adenoidal hypertrophy, allergic rhinitis, chronic sinusitis and neoplasm of the nose.


When patients are in the late stages of HIV infection, atypical opportunistic infections can occur in the nose or par nasal sinuses, and fungal sinusitis would be one such infection.


The diagnosis and treatment of sinusitis in this population is similar to that for non-HIV infected patients. Signs and symptoms can include fever, headache, localizing symptoms, and mucopurulent nasal drainage. In many patients, often initial findings relate primarily to the pulmonary system with recurrent bacterial pneumonias and bronchospasm.


Standard outpatient medical therapy is often effective in this patient population. Clinicians must rigorously employ a dual approach which includes an antibiotic as well as a decongestant. Amoxicillin may be used for primary treatment, however, amoxicillin with clavulanate or an oral cephalosporin, such as cefuroxime is often more effective.


Oral antibiotic therapy should continue for a minimum of 3 weeks. In patients resistant to therapy or with evidence of actual or impending extra-sinus complications, hospital admission for intravenous antibiotics, surgical drainage, or both is imperative



Esther Smith, author

References for this article taken from the research writings of Kelvin C Lee, MD, Univ of California and Thomas A. Tami, MD, Univ of Cincinnati. For more sinusitis information go to: