Sinus Infection Quiz

Most sinus infections are viral infections—part of the “common cold.” However, even when bacteria is involved, about 50% of cases will get better without antibiotics within 10-14 days. This quiz will help us determine the severity of a sinus infection and whether antibiotics are warranted.

Or, if you prefer just to discuss or schedule a clinic visit, let us know!

1. Emergency Screen
Right now, are any of these present? Any one could be a medical emergency: swelling, redness, or bulging around an eye; new trouble seeing or double vision; a severe or rapidly worsening headache; confusion or trouble staying awake; a stiff neck; or a seizure.
2. How many days have symptoms lasted?
3. Are symptoms getting better, staying the same, or getting worse?
4. Fever 102°F (39°C) or higher?
Answer Yes only if measured with a thermometer.
5. Thick colored (yellow or green) nasal mucus?
Answer Yes only if the mucus has been thick and colored for 3 or more days in a row.
6. Do sinus problems keep coming back or never fully go away?
Chance This Is Bacterial
Under 2%
This is based on at-home answers, which are less exact than an in-person exam.
You can paste these results in a message to share with your doctor or nurse at the clinic. They will reply with the appropriate next steps.
Clinical Citations & Scoring Logic

Diagnostic Logic (IDSA / AAO-HNS 2025): Acute Bacterial Rhinosinusitis (ABRS) is diagnosed pattern-wise when viral illness is exceeded. Viral URI duration is typically <10 days. Bacterial infection is presumed with:

  • Persistent: Symptoms lasting ≥10 days without improvement.
  • Double-sickening: Worsening symptoms, new fever, or increased discharge after initial viral improvement.
  • Severe early onset: High fever (≥102°F/39°C) + thick purulent discharge continuously for ≥3–4 days at start.

References:

  • Payne SC, et al. Clinical Practice Guideline: Adult Sinusitis Update. AAO-HNS, 2025.
  • Harris AM, et al. Appropriate Antibiotic Use for Acute Respiratory Tract Infection in Adults. Ann Intern Med, 2016.
  • Butler FM, Hernandez DR. Acute Rhinosinusitis: Rapid Evidence Review. Am Fam Physician, 2025.
  • Rosenfeld RM. Acute Sinusitis in Adults. N Engl J Med, 2016.
  • ACR Appropriateness Criteria Sinonasal Disease, 2021 Update.