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Chronic sinusitus as underlying infection

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Very Intersesting! How do you know when it's a fungal sinus infection? My daughter had monthly sinus infections since age two, which we always treated with abx's and no doctor ever mentioned this. I always complained of the extreme behaviors (before i knew of Pandas) during her infections, but mostly heard "she's young, she's sick". I was always told it was due to allergies but in between infections she was symptomless and of course, her panda-ish behavior went away with the abx. Ironically, since her major onset of Pandas (3 1/2 years ago), she has less sinus infections but instead more typical Pandas episodes. And now chronic...


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My dd has had chronic phlegm or sinusitus since her excerabation in May. The abx amoxicillan and augmentim help lessen it but not KILL it. She just went off augmentim to clear her system for the Igenex lyme test and the phelgm/sinusitus is REALLY coming back strong. Remember I posted Dr K said she will have this as long as she has PANDAS.... My question is for those who have dealt with chronic sinusitus, which abx have worked for you and at what dosgae? Is there any other treatment for sinusitus?


We are also waiting on second myco test to see if that number has gone down.


Thank you~ you are all so helpful!

PANDAS McNuggets w/fry/coke


I think a research team from the Mayo Clinic found that fungal allergy was responsible for MOST chronic sinusitis in the late 1990s, so many doctors just move on to antifungals if antibiotics do not work.


They can also culture the nasal mucous an look for eosinophils.


In our case, we found out at his first sinus surgery when they cultured the mucus and mucosa that was removed and it tested positive for fungus.


As far as treatment, Dr. Sherris, who was the lead researcher from the Mayo Clinic, recommends doing a nasal rinse with an antifungal wash and has found good results with this with adults. The problem we had is that you have to just about stand on your head to get it into the sinuses, and my son felt like he was going to die (may have been his OCD issues at the time) when we tried to do it. It is far more invasive than a simple neti pot rinse. Here a video about it http://www.drsherris.com/videos/vob5.wmv


So... our ENT prescribed a course of diflucan instead, and now we do both antibiotics and diflucan for all sinus infections. Here is some info. on using diflucan or other antifungals:


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Thanks Kim! My daughter just started taking Kolorex Practitioner Candida Care (active horopito extract) to maintain normal candida levels. Does this sound like an antifungal? First time ever taking something prescribed for yeast. But we do give her Florastor (good yeast) everyday to keep away c-diff.

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For kids who balk at a Neti (and grown ups too), we use this (the junior size version)



It's a syringe - eliminates the need to be a contortionist. The only warning my own allergist had was to make sure you compress the syringe slowly. If you shoot the saline into your nose too quickly, it can force water into the ear canal and cause an ear infection. But if you do it at a moderate pace, it's ok (you have to push the syringe fast enough to trigger the reflex that closes your epiglotis and prevents you from choking but slow enough that you force water into the ear canal). It sounds hared than it really is. Also, use warm water. If it's too cold or too hot, you get a headache for a few minutes - sort of a brain freeze.


It's not ideal, but if you feel a neti is helpful but can't get your child to do it, this might do the trick. We find it shortens the durations of colds if you use it daily at the early signs of something coming on. Once the cold is full bore, I would not use it, as trying to send water up into a blocked passage with the syringe can be harmful/painful. That's the beauty of Neti - it uses gravity so it's easier to control the force of the salt water. I guess you pick your poison.

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Yeah, I've been using one for a couple of months. Recently switched to the squeeze bottle style for more "force." Unfortunately, it hasn't made a difference as far as I can tell.


No way would my kids do this, especially PANDAS son during exacerbation! (Well... maybe if it was an energy drink instead of saltwater?)



Has anyone tried a netipot? http://www.webmd.com/allergies/sinus-pain-pressure-9/neti-pots


I would also vote for a good doses of Azith. Our 62 pounder (not-sinusitis, but just giving an example of dosing) has been on 250mg/day Aztih. for over 2 years (started at this dose at 42 pounds). There was 1 mo. during a flare where we upped to 500mg/day. So, I wouldn't be nervous at all about giving a bigger kid (115 pounds) 500mg/day for at least a month.


Also, try to stay away from anti-histamines. They can be bad if you have a sinus infection, since it dries them out too much.

Edited by Worried Dad
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  • 3 months later...

On the MRI, my child shows some sinus trouble but she never has a cold. She gets very stuffy on winter nights though. Does everyone with sinus problelms sneeze or sound congested?

No - you don't always see sneezing or congestion - especially not if it is up in the ethmoid sinuses. My son had a very bad sinus cyst last year and he did not have any sinus symptoms for most of the time. He had PANDAS symptoms. When we checked his sinus to figure out what was causing the PANDAS we found the cyst. This year he had some post nasal drip and headaches. We found sinus inflammation and Dr. B put him on 2 weeks of steroids to calm down the inflammation and he is doing better now.

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I had to knock this out for myself and I did it without pills. I got a Neti Pot for fifteen bucks and irrigated my sinuses each night for a week. I also started using Oil of Oregano concentrate diluted for sublingual and breathing in application. I didn't do the breathing the vapor procedure, but it will kill any infection in the sinus. Sublingual should also kill any strep in the throat. Oil of Oregano tastes really bad though. It's more concentrated than the oregano you are used to on Pizza. You can find several different guides through google on getting rid of sinus infections. They work well in my experience.


Up to a third of blocked sinuses are due to infection not allergies. Noses carry nasty stuff. I also used Bacitracin on a cue tip up the nostrils before bed each night which killed the strep up there too. You will find the bacitracin remedy online as well. Neti + Oil of Oregano + Bacitracin will kill any sinus infection and keep it away.

Edited by Hierge
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