Rhinosinusitis / Persistent runny nose
A runny nose is extremely common in young children. It is usually caused by coughs and colds, which your child can catch repeatedly, especially over the winter months. It is more common in children attending nursery/childcare. A cold typically lasts 7-10 days but when your child catches another infection before they have fully recovered for the first time it can seem like it is going on forever! Very few children with persistent runny noses require prescribed treatments such as antibiotics.
Symptoms that suggest specific treatment is required include:
- Persistent offensive discharge (green or bloody mucus) lasting longer than 10 days
- Completely blocked nose
- Pain and tenderness on one side of the face, around the eyes or forehead
- Headache
- Fever
When should you worry?
If your child has any of the following:
- Becomes pale, mottled and feels abnormally cold to touch
- Has blue lips
- Has a fit/seizure
- Develops double vision
- Becomes extremely agitated (crying inconsolably despite distraction), confused or very lethargic (difficult to wake)
- Develops a rash that does not disappear with pressure (the 'Glass Test')
- Is under 3 months of age with a temperature of 38°C / 100.4°F or above (unless fever in the 48 hours following vaccinations and no other red or amber features)
You need urgent help.
Go to the nearest Hospital Emergency (A&E) Department or phone 999.
If your child has any of the following:
- Severe pain in eyes
- Redness and swelling of the skin around the eyes
- Is complaining of a severe headache and neck stiffness/pain or discomfort with bright lights (photophobia)
- Changes in vision including flashing lights (vision can appear blurred or misted because of discharge smeared over the surface of the eye, but this will usually clear on blinking or wiping the eyes)
- Severe headache persisting despite regular painkillers (ibuprofen and paracetamol) or worse on lying down / in morning
- Becomes unsteady on their feet
- Persistent vomiting
- Is becoming drowsy (excessively sleepy) or irritable (unable to settle them with toys, TV, food or picking up) - especially if they remain drowsy or irritable despite their fever coming down
- Babies under 28 days with a red eye(s) or lots of thick pus from their eye(s). A sticky eye(s) without redness or swelling is quite common in babies due to blocked tear ducts - this does not require review by a doctor
- Is having breathing problems, such as rapid breathing, shortness of breath or laboured breathing (drawing in of muscles below the lower ribs when they breathe in)
- Seems dehydrated (sunken eyes, drowsy or no urine passed for 12 hours)
- Has extreme shivering or complains of muscle pain
- Continues to have a fever of 38.0°C or above for more than 5 days
- Is getting worse or if you are worried
You need to contact a doctor or nurse today.
Please ring your GP surgery or contact NHS 111 - dial 111 or for children aged 5 years and above visit 111.nhs.uk
If none of the above features are present
Self care
Continue providing your child’s care at home. If you are still concerned about your child, contact NHS 111 – dial 111 or for children aged 5 years and above visit 111.nhs.uk
Advice and Guidance
Self care and Prevention
Causes of rhinosinusitis
Most cases of rhinosinusitis in children are caused by an infection; your child may also have a sore throat, cough or earache.
Treatment
Most children with rhinosinusitis do not need treatment with antibiotics - they recover just as quickly without them and can avoid some of the side effect that antibiotics can cause.
If your child has any features of severe infection (amber or red features), they will need to be assessed urgently by a healthcare professional.
You can help relieve symptoms by:
- Giving your child paracetamol or ibuprofen to help relieve pain
- Holding a warm clean flannel over their face for a few minutes several times day
- Encourage your child to drink plenty of fluids
It can take up to 2 weeks for a child to fully recover from rhinosinusitis.
This guidance is written by healthcare professionals from across Hampshire, Dorset and the Isle of Wight.
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