Chronic Sinus Infections and Cystic Fibrosis

Reviewed by: HU Medical Review Board | Last reviewed: September 2019

Respiratory complications are the most common complications of cystic fibrosis (CF), including the nose and sinuses, which make up the upper respiratory system. Sinusitis (inflammation of the sinus cavities) and chronic (long-term) sinus infections can be frequent.

How cystic fibrosis causes respiratory complications

That’s because CF’s faulty gene prevents the normal flow of salt and water in and out of the lungs and other organs, creating a thick, sticky mucus. This mucus provides an exceptional breeding ground for many bacteria and viruses.1-2

The sinus cavity is made up of four pairs of air-filled spaces in the head. When these spaces become inflamed, it is called sinusitis. The inflammation of sinusitis can make it even harder for the mucus created by CF to move out of these spaces. In people with CF, it is common for nasal polyps to block drainage from the sinuses. Inflammation, extra thick mucus, and nasal polyps can work together to block drainage, thereby creating a breeding ground for infection. This is known as a sinus infection.

Common causes of chronic sinus infections

A pathogen is a term for any infectious organism or germ that causes disease, such as a virus, bacteria, fungus, protozoa, or prion. The bacteria and viruses people with CF most often get include:

  • Staphylococcus aureus (staph)
  • Haemophilus influenza (flu)
  • Pseudomonas aeruginosa
  • Burkholderia cepacian
  • Achromobacter (Alcaligenes or Acinetobacter) xylosoxidans
  • Stenotrophomonas maltophilia2

These pathogens tend to quickly lead to exacerbations, or serious illness in people with CF. Because people with CF battle these infections so often, they tend to be at risk for antibiotic resistance. Antibiotic resistance refers to the prolonged use of antibiotics that leads to the antibiotics no longer being effective.

What are symptoms of chronic sinus infections?

Common symptoms of a sinus infection are:

  • Stuffy nose or trouble breathing through the nose
  • Green or yellow mucus
  • Pain in the face
  • Sore throat or cough (from post-nasal drip)
  • Headache
  • Mouth breathing
  • Poor sense of smell or reduced sense of hearing,
  • A constant need to clear the throat.2

People with CF often also have nasal polyps, and about 20% of people with CF also experience allergies that make them more vulnerable to sinus infections.2

Treatment for chronic sinus infections

Chronic sinus infections are generally treated with a combination of therapies and what works may vary widely from person to person. These include:

  • Antibiotics to control the infection
  • Nasal steroids
  • Antihistamines and decongestants to open up the sinuses
  • Sinus irrigation (flushing) to loosen mucus1,2

In the most severe cases, surgery may be needed to drain the sinuses.1 People with CF, and their friends and family can take many steps to reduce their risk of infection.

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