In Goa's high-humidity environment, recurrent sinusitis that responds to antibiotics and returns within weeks is one of the most common patterns I see at my center in Margao - and in the large majority of these cases, the antibiotics are treating the secondary bacterial infection without addressing the primary allergic inflammation that keeps creating the conditions for that infection to occur. The mechanism: allergic rhinitis from house dust mite, mould, or cockroach sensitisation produces mucosal oedema in the nasal passages that chronically obstructs the sinus drainage passages. Bacteria grow in the stagnant mucus behind the obstruction. Antibiotics clear the bacteria. But the allergic inflammation is still there, the obstruction returns, and the cycle repeats. The solution is identifying the specific allergen driving the nasal inflammation through clinical assessment and allergy evaluation, and addressing it with appropriate treatment - allergen avoidance in the Goan home environment, intranasal anti-inflammatory therapy, and where indicated, allergen immunotherapy to modify the underlying immune response. When the allergy is treated, the sinusitis episodes reduce in frequency and severity, often dramatically.
Written by Dr. Nivedeeta Pereira, DLO (Diploma in Otorhinolaryngology/ENT), AASC (Advanced Allergy and Asthma Specialist Course), AAAIC (Advanced Allergy and Asthma in Clinical Immunology), ENT Specialist and Allergy, Asthma and Upper Airway Care, Dr. Nivedeeta's ENT and Allergy Center, Margao, Goa. 11 years, 10,000+ patients. Phone: 8007048189.
