Nonetheless, sinusitis is common among the elderly. Causes include dental infections, obstruction due to a nasal polyp, and upper respiratory tract infections. In the elderly, a common cause of acute sinusitis is the packing used for treatment of epistaxis. Symptoms, Signs, and Diagnosis Symptoms are similar in elderly and younger patients. The area over the affected sinus may be tender and swollen.
Facial pain occurs in various sites depending on which sinus is affected.
Patients report congestion and may have bad breath, a general feeling of malaise, and yellow or green purulent rhinorrhea. The nasal mucosa is red and swollen, and a purulent exudate may be present. Fever and chills suggest that the infection has spread beyond the sinuses. A malodorous, purulent nasal discharge suggests a dental root abscess that has erupted into a maxillary sinus. If a patient has nasal or cheek swelling, unilateral or bilateral nasal obstruction, and a purulent or bloody discharge, the cause may be nasal or sinus neoplasia, rather than sinusitis.