How to treat pneumococcal sinusitis?

Question

Hello doctor,

My mother is 54 years old and has had chronic sinusitis for many years. But recently the doctor diagnosed her condition as pneumococcal sinusitis. She has been experiencing facial pain, severe nasal congestion, fever, and fatigue for almost the last two weeks. She completed a course of Amoxicillin medicine but symptoms did not resolve. The CT scan report of her sinuses showed prominent mucosal thickening and also a blockage in the ethmoid and maxillary sinuses. Her blood profile is also bad. The doctor has now put her on a very high dose of Amoxicillin-Clavulanate, and given her corticosteroid and saline nasal spray but still, we cannot see any improvement in her health. Is she resistant to the medication prescribed to her or does she have some other issue which is not being detected with these tests? Should we go for a culture test or any other test? I heard about complications she might get in the future like brain abscess or orbital cellulitis. Is it curable? Will she survive after surgery is done to drain the sinuses?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and understand your concern.

Persistent symptoms may indicate antibiotic resistance, inappropriate antibiotic choice, or a secondary issue like a fungal infection or anatomic obstruction.

As you said, plan for a culture and sensitivity test from a nasal or sinus swab to identify the specific pathogen and guide targeted antibiotic therapy.

CBC (complete blood count), CRP (C-reactive protein), and ESR (erythrocyte sedimentation rate) tests can help assess the infection's systemic impact. If the issue persists, you need to plan for an MRI (magnetic resonance imaging) too. Complications such as orbital cellulitis or brain abscess are rare.

Early intervention, including surgery to drain the sinuses (functional endoscopic sinus surgery), can significantly reduce risks and improve outcomes. With appropriate medical and surgical care, her condition is highly treatable, and the prognosis is generally good.

I hope I have answered your question.

Let me know if I can assist you further.

Regards.