FAMILY MEDICINE® COLUMN
By John C. Wolf, D.O.
Associate Professor of Family Medicine®
Ohio University College of Osteopathic Medicine

SINUS INFECTION ONE POSSIBLE CAUSE OF SON'S SYMPTOMS

Question: Our son gets frequent colds. He seems to spend all winter with a runny nose. Do his frequent colds mean he has something wrong with his immune system?

Answer: It is unlikely that your son has an immune system problem, but it is something his doctor will consider. I think that there are several other more common conditions that may be responsible for his repeated runny nose.

Most perfectly healthy children catch three to five colds each winter. This common viral illness produces a runny nose, cough and sore throat that usually clears up in a week or so. Children catch colds more frequently than adults because of several reasons. One of these is related to the immune system.

The immune system must first recognize an invading cold virus as something that is unwanted before it can make antibodies to stop the infection. Most adults have had many colds throughout the years, and this makes it possible for their immune systems to shift immediately into production of disease-fighting antibodies when they encounter the same or a similar virus. This is why adults often show milder or perhaps no cold symptoms after exposure to a cold-causing virus. Because a child hasn't had as many viral infections as an adult, there is a delay between exposure to the virus and the start of antibody production by the immune system. It is during this delay while the immune system is busy trying to figure out what has invaded the body that the child develops all the typical symptoms of a cold.

The second reason school-age children get frequent episodes of coughs and colds is that they don't worry a bit about coughing and sneezing on each other. This quickly spreads any infection throughout the classroom and then to the family.

Your child may have a constant runny nose for reasons other than repeated colds. One of the most common causes for this is sinusitis a bacterial infection within the sinus spaces. This happens in about 2 percent of children that catch a cold. And considering the number of colds children suffer each year, you can see that sinusitis is a significant problem.

When a child has a persistent cough during the daytime and this symptom lasts for more than 10 days, you might suspect sinusitis. On the other hand, a persistent cough at nighttime usually means a cold. A runny nose is the other typical symptom. The drainage is usually thick and yellow-to-green colored, but it can be thinner and colorless. A postnasal drip, a morning sore throat, nasal blockage and mouth breathing are also common. The facial pain and headaches that are typical of sinusitis in adults are reported by only one-third of children. Some children with sinusitis have persistent foul breath, although there are other causes for this as well. Children may also complain of pain in the upper teeth. This pain can be the result of sinus pressure irritating the nerve that goes to the teeth, or due to infected teeth spreading infection into the sinus space. It usually takes X-rays to decide which is the cause.

Some children with sinusitis have swelling around one or both eyes. This is a sign of a potentially serious complication and requires prompt medical attention. I hope your child will not develop this complication.

So talk to your son's doctor. He or she will look into many possible causes for the frequent episodes of runny nose. But don't feel you've wasted your time and money if you're told your son just has lots of friends that share their colds with him.

Family Medicine® is a weekly column. To submit questions, write to John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.