Question

I have had ongoing sinus issues for a couple of years now, probably worse in the Fall and Winter. Last winter it seemed like I could never get over sinus infections. At that time I had a nasal cat scan, which the doctor seemed pretty unimpressed with and so I decided to ignore it and just live with my issues. I take Sudafed Nighttime every night and during the day, I take regular Sudafed when I need it.

Usually when I blow my nose, a lot of fairly thick, unclear but generally not too discolored mucus comes out from way up in my sinuses. It almost always smells funky to me. It has a bleach scent. On occasions, a fairly solid mass of pea green stuff came out. It also had that odor. Today it was the size and consistency of a canned pea with the same color maybe even darker. It almost looks like the color of a fresh pea.

This is sort of disgusting and I really don't like even telling my doctor about it, although it's usually the nurse who asks those questions initially on the phone or when you get to the office. I really don't like talking about it to them. I'm sure they would find it totally disgusting!

Anyway...I'm not sure what it is or why it is only occasional. That is why I don't really think it is from an infection although the color would definitely indicate that something was less than normal. Also when I blow my nose my ears pop and on some days I have facial pain behind my sinus areas, which is when I take Sudafed and Advil.

Please advise. Thank you.

Advice 1

You may in fact have a chronic sinus infection. Although this may be due to a bacterial overgrowth (normal sinuses generally have few bacteria) it could also be due to a fungus infection. The CAT scan has eliminated the possibility of growth such as nasal polyps. Some people with chronic nasal congestion/discharge (of varying colors and consistencies) have allergies to environmental things such as dust, pollens, dander, etc. Which can respond to anti-allergy medications such as nasal cromolyn or nasal steroids or even allergy desensitization shots. I would check with an ENT doctor first and then perhaps an allergist. Good luck.

Advice 2

It appears that you have chronic sinus infection, allergy or both. Since the CAT scan does not show significant pathology, you may try to take care of the problems by medication. Did you have any cultures done? I'd suggest that you bring the materials that came out from your sinus to the laboratory for culture and sensitivity tests. If any microorganisms are detected, appropriate antibiotics should be used to treat the infection.

Advice 3

Your problem may not be infectious but may be more allergic or environmental in nature. You then could have a supra infection on top of the initial inflammation. I would start with a repeat CT of the sinuses if the old one were about a year old. You need to make some major environmental changes including removing carpeting, avoiding pets, cleaning AC/heating ducts, increasing ambient in door humidity to >45%. You should be evaluated for a possible course of antibiotics, and start on antihistamines and nasal steroids. An evaluation by an allergist could be beneficial. Also look for environmental exposures at work, which may be contributing. Good luck.