Children's Hospital Colorado

Sinusitis in Children

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What is sinusitis (sinus infection)?

Sinusitis, or rhinosinusitis, is more commonly called a sinus infection. The condition occurs when the sinuses become inflamed or infected.

Everyone has four pairs of sinuses, which are hollow spaces in the bones, around the nose:

  • Maxillary sinuses: Located below the eye sockets
  • Ethmoid sinuses: Located between the eye socket and the nasal cavity
  • Frontal sinuses: Located right above the eyebrows
  • Sphenoid sinuses: Located deep in the nose behind the ethmoid sinuses

Young children only have maxillary and ethmoid sinuses — the frontal and sphenoid sinuses develop in the teen years.

Healthy sinuses are filled with air. When sinuses get inflamed or infected, the lining thickens and bacteria-filled mucus fills the sinus cavity.

Doctors classify sinus infections by how long they last:

  • Acute: Infections lasting up to 4 weeks
  • Subacute: Infections lasting 4 to 12 weeks
  • Chronic: Infections lasting more than 12 weeks
  • Recurrent: Infections that occur repeatedly, with short intervals of no symptoms in between

What causes sinus infections in children?

Sinusitis generally starts as a viral upper respiratory infection such as the common cold. Cold symptoms that last longer than 10 days increase the chance of a sinus infection.

When your child has a cold, the lining of their nose and sinuses gets inflamed and swollen. Many different types of bacteria, including those that cause sinusitis, can then move into the nasal cavity.

Other risk factors that increase the chances of sinus infections in children include: 

  • Being in a school or daycare setting
  • Having older siblings
  • Being around pets
  • Exposure to secondhand cigarette smoke
  • Exposure to other environmental allergens
  • Deviated septum, enlarged adenoids or other structural differences

How common are sinus infections in children?

Children get colds more often so they are likely to get acute sinusitis at some point. Only a small number of children develop chronic sinusitis. However, an immune deficiency or weakened immune response increases the risk of chronic sinusitis.

Why does my child keep getting sinus infections?

Research shows a link between allergic diseases, such as hay fever and asthma, and recurrent sinus infections. Other conditions that increase the risk of recurrent sinusitis in children include:

  • Resistant bacteria
  • Cystic fibrosis
  • Anatomic differences, such as a deviated septum or enlarged adenoids

Resistant bacterial infections are infections with bacteria that don’t respond to antibiotics. They occur with repeated antibiotic use, or from infections caused by resistant bacteria that spread from person to person. Even when treated with antibiotics, resistant bacteria continue to multiply — making these infections difficult to treat. Instances of resistant bacterial infections are rare.

Children with compromised immune systems, such as those with cancer, type 1 diabetes and type 2 diabetes, can get invasive fungal sinusitis (an infection that occurs after inhaling certain types of fungus) in addition to bacterial sinusitis. For these children, the condition can become fatal without proper treatment.

Get to know our pediatric experts.

Allison Dobbie, MD

Allison Dobbie, MD


Gregory Allen, MD

Gregory Allen, MD

Otolaryngology, Pediatric Otolaryngology

Norman Friedman, MD

Norman Friedman, MD

Otolaryngology, Sleep Medicine

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Mark Willis, MD

Mark Willis, MD


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