Adult Sinus Infection Treatment (Acute Rhinosinusitis) in Texas
Fast MD-only sinus care by video, $49 flat-fee, no insurance required.
Sinus pressure, facial pain, nasal congestion, and thick nasal discharge are common with sinus infections. Most cases start as viral upper respiratory infections, and only a subset progress to true acute bacterial rhinosinusitis that benefits from antibiotics. Our board-certified MDs use guideline-based criteria to distinguish viral from bacterial sinusitis by video visit and prescribe antibiotics only when appropriate.
- Board-certified MD every visit
- Video-only care, no waiting rooms
- $49 flat fee, no insurance needed
- Antibiotics prescribed when medically appropriate
What Is a Sinus Infection?
Acute rhinosinusitis is inflammation of the nasal passages and sinus cavities, most often caused by viruses. Symptoms include nasal congestion, facial pressure or pain, thick nasal discharge, and reduced sense of smell. When symptoms are severe, last longer than expected, or worsen after initial improvement, a bacterial sinus infection may be present.
TeleDirectMD focuses on acute sinus infections in otherwise healthy adults. During your secure video visit, a TeleDirectMD physician reviews the timing and pattern of your symptoms using guideline-based criteria to help distinguish viral from bacterial sinusitis and screens for warning signs that require in-person care. As long as you are physically located in Texas at the time of your visit, we can evaluate your sinus symptoms and, when appropriate, send prescriptions to your local Texas pharmacy.
Typical Symptoms Versus Red Flags
Many sinus and nasal symptoms can be safely evaluated online, but certain patterns suggest complications that require urgent in-person assessment. The table below compares common findings.
| Symptom pattern | More likely uncomplicated viral or mild bacterial sinusitis | Suggests more serious infection | Red flag (seek urgent in-person care) |
|---|---|---|---|
| Duration of symptoms | Nasal congestion and facial pressure for less than 10 days, gradually improving | Symptoms lasting 10+ days without improvement | Sudden, very severe headache with neck stiffness or confusion |
| Symptom course | Gradual onset during a cold, then slow improvement | “Double worsening” – initial improvement then new or worse symptoms | Rapid deterioration with high fever and severe facial pain |
| Facial pain or pressure | Mild to moderate pressure over cheeks or forehead | Localized severe pain on one side of the face | Severe, persistent facial pain with swelling or redness around the eye |
| Nasal discharge | Clear or slightly discolored mucus that gradually improves | Thick, purulent nasal discharge for several days | Persistent foul-smelling discharge with high fever or vision changes |
| Fever | No fever or low-grade fever only | Fever ≥ 100.4°F (38°C) lasting several days | High fever with chills, confusion, or neck stiffness |
| Eye or neurologic symptoms | Mild pressure around the eyes without vision changes | Significant eye pain or swelling with sinus symptoms | Vision changes, double vision, severe eyelid swelling, confusion, or difficulty speaking |
When a Video Visit Is Appropriate
- Age 18 or older
- Nasal congestion or stuffiness
- Facial pressure or pain over cheeks or forehead
- Thick nasal discharge without severe eye swelling
- Mild to moderate headache
- No confusion, stiff neck, or severe neurological symptoms
- Able to drink fluids and take oral medications
- No severe shortness of breath or chest pain
- No recent major facial trauma or sinus surgery complications
Red Flag Symptoms, In-Person or Emergency Care
- Fever ≥ 100.4°F (38°C) with severe headache or facial pain
- Severe swelling or redness around one or both eyes
- Vision changes, double vision, or difficulty moving the eye
- Neck stiffness, confusion, or trouble speaking
- Severe, sudden “worst headache of your life”
- Persistent vomiting or inability to keep down fluids or medications
- Severe facial pain in someone who is immunocompromised
- Recent sinus or brain surgery with new severe symptoms
- Shortness of breath, chest pain, or signs of systemic illness
How TeleDirectMD Treats Adult Sinus Infections
Supportive Care Measures
- Using saline nasal rinses or sprays to help clear mucus and improve drainage
- Considering intranasal steroid sprays for inflammation when appropriate
- Using over-the-counter pain relievers such as acetaminophen or ibuprofen when appropriate
- Maintaining adequate hydration unless restricted for another condition
- Using a humidifier or steamy showers to help ease congestion
- Avoiding smoking and exposure to secondhand smoke
When Antibiotics Are Appropriate
Antibiotics are reserved for adults who meet evidence-based criteria for acute bacterial rhinosinusitis, such as persistent symptoms beyond 10 days without improvement, severe symptoms with high fever and purulent discharge, or “double worsening” after an initial period of improvement. During your video visit, your MD confirms that:
- You have a symptom pattern consistent with likely bacterial sinusitis
- You do not have red flag symptoms that require urgent in-person care
- Your medication allergies and other conditions are reviewed
- Other serious diagnoses, such as orbital or intracranial complications, are unlikely based on your history
Common Adult Antibiotic Regimens When Indicated
| Antibiotic | Typical adult dose | Usual duration | When we use it |
|---|---|---|---|
| Amoxicillin–clavulanate | 875/125 mg BID | 5–7 days | Common first-line option for likely acute bacterial sinusitis in otherwise healthy adults, when no significant allergy is present. |
| Doxycycline | 100 mg BID | 5–7 days | Alternative for adults who cannot take amoxicillin–clavulanate or have certain penicillin allergies. |
| Amoxicillin (high dose) | 1000 mg TID | 5–7 days | Option in selected adults when resistance risk is lower and there is no beta-lactam allergy. |
Fluoroquinolone antibiotics are not used as routine first-line choices for uncomplicated sinus infections because of potential side effects and antibiotic stewardship principles. TeleDirectMD does not prescribe controlled substances for sinus symptoms.
Home Care Tips for Sinus Symptoms
- Drink fluids regularly through the day unless restricted for another condition.
- Use saline sprays or rinses to help thin and clear mucus.
- Sleep with your head slightly elevated to reduce congestion.
- Use a cool-mist humidifier if your indoor air is very dry.
- Follow your MD’s directions for any prescribed medications and complete the full course if antibiotics are given.
Return to Work Guidance
Many adults can continue working or return to work when their pain and congestion are controlled enough to perform usual tasks. If fever was present, being fever free for at least 24 hours without fever-reducing medication is a reasonable threshold before returning to work in most settings. Your MD can provide a simple work note when medically appropriate. TeleDirectMD does not complete disability, FMLA, or long-term workplace accommodation paperwork.
TeleDirectMD provides evidence-based virtual urgent care for adults, including sinus infections, respiratory symptoms, urinary tract infections, skin concerns, and medication refills. All visits are with a board-certified MD by secure video, with clear guidance for when in-person care is required instead of telehealth alone.
Adult Sinus Infection Questions and Answers
Can a doctor diagnose a sinus infection by video visit?
In many adults, yes. Acute sinus infections are usually diagnosed based on your symptoms, timing, and exam findings that can be assessed by video. During your TeleDirectMD visit, an MD reviews how long you have been sick, whether your symptoms are improving or worsening, and any red flags to decide if your illness fits uncomplicated sinusitis or requires in-person evaluation.
How do you tell if a sinus infection is viral or bacterial?
Viral infections typically improve within 7–10 days. Bacterial sinusitis is more likely when symptoms last 10+ days without improvement, are very severe from the start, or worsen after initial improvement. Your TeleDirectMD physician uses these patterns, along with your overall health and risk factors, to decide whether antibiotics are appropriate.
Do I always need antibiotics for a sinus infection?
No. Many sinus infections are viral and improve with supportive care alone. Antibiotics are reserved for adults who meet guideline-based criteria for likely bacterial sinusitis. During your visit, your MD will explain whether your symptoms suggest bacterial infection or are more consistent with a viral illness.
How long does it take to feel better after starting treatment?
With appropriate treatment, many adults notice some improvement in congestion and facial pressure within a few days. Full recovery can take 1–2 weeks. If symptoms are worsening after several days of treatment, or you develop new red flag symptoms such as high fever, eye swelling, or vision changes, you should seek in-person care promptly.
Can TeleDirectMD prescribe nasal sprays for sinus symptoms?
Yes. When appropriate, your TeleDirectMD physician can recommend or prescribe nasal steroid sprays and other medications that support sinus drainage and reduce inflammation. Over-the-counter options and prescription choices can both be discussed during your visit.
Is TeleDirectMD available throughout Texas for sinus infection care?
Yes. As long as you are physically located in Texas at the time of your visit and can access a local pharmacy, you can use TeleDirectMD for sinus evaluation. This includes adults in Houston, Dallas, Austin, San Antonio, Fort Worth, El Paso, and rural counties across the state.
When should I go to urgent care or the emergency room instead?
You should seek in-person care urgently for red flags such as high fever with severe headache, swelling or redness around the eyes, vision changes or double vision, neck stiffness, confusion, very severe sudden headache, or trouble speaking. These symptoms can signal serious complications that cannot be managed by telehealth alone.
Can I get a work note for my employer?
Yes. When medically appropriate, your TeleDirectMD physician can provide a brief work note confirming that you were evaluated and outlining a reasonable timeframe to return to work. TeleDirectMD does not complete disability forms, FMLA paperwork, or detailed workplace accommodation letters.
Does TeleDirectMD take insurance for sinus visits?
TeleDirectMD visits are offered at a $49 flat fee and are not billed to insurance. Pharmacy and laboratory costs are separate and may be submitted to insurance or paid directly, depending on your coverage and preferences.
Who will I see during my online sinus infection visit?
All TeleDirectMD visits are provided by licensed physicians. You will see an MD, not a nurse practitioner or physician assistant, for your sinus infection evaluation and treatment plan.