Conditions
Sinus infection in Puerto Rico: online treatment
A sinus infection in Puerto Rico can be treated by video: it causes a stuffy nose, thick mucus and pain or pressure in the face, and usually follows a cold. The doctor assesses your symptoms, tells you how to ease them and, if there are signs of a bacterial infection and it is appropriate, prescribes and we send your prescription to your pharmacy. We see all ages.
Is it an emergency? Call 911.
Is this an emergency?
This is not an emergency service. Call 911 or go to the nearest emergency room if you have:
- Swelling or redness around the eye
- Double or blurred vision, or any change in vision
- Severe headache or a stiff neck
- New confusion or unusual drowsiness
- High fever with worsening illness
- A baby under 3 months with a temperature of 100.4 °F (38 °C) or higher
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At a glance
Sinus infection (sinusitis)
Common symptoms
- Stuffy or runny nose
- Pain or pressure in the face, behind the eyes or in the upper teeth
- Headache
- Mucus dripping down the throat and a sore throat
- Cough, often worse at night
- Bad breath or loss of smell
- Tiredness and sometimes fever
- Other names
- Rhinosinusitis · Acute sinusitis
- Treatment
- Home care; an antibiotic only if the medical evaluation suggests a bacterial infection
- Possible complication
- Infection around the eye (orbital cellulitis), rare
On this page(10)
What is a sinus infection?
Sinusitis is inflammation of the sinuses, the air spaces behind your forehead, cheeks and nose. Most sinus infections are caused by the same viruses that cause colds and clear up on their own within a week or two; some are bacterial.
Green or yellow mucus does not by itself mean the infection is bacterial or that you need an antibiotic. Poorly controlled allergies, tobacco smoke and mold can also cause or worsen sinusitis. MedlinePlus lists toothache among the symptoms, because pressure in the cheek sinuses is felt in the upper teeth; if the pain comes from one tooth, see toothache.
Sinus infection in Puerto Rico: how we treat it by video
You see Dr. Diana Nieves Castro, a Puerto Rico–licensed general practice physician with several years of emergency-department experience, in English or Spanish. She asks how long you have had symptoms, whether they improved and then got worse, whether you have fever, facial pain or headache, allergies or asthma, and what you have already taken. She also asks you to show your face and the area around your eyes on camera.
She then tells you whether this is most likely a viral sinus infection, treated with home care, or whether it meets the criteria for a bacterial infection. If appropriate, the doctor prescribes and we send your prescription to your pharmacy. We never promise an antibiotic before the evaluation: read can telehealth prescribe antibiotics.
We see adults, teens, children and babies. You need to be physically in Puerto Rico during the visit; visitors are welcome.
Your doctor
Dr. Diana Nieves Castro, MD
General practice physician
Several years of emergency-department experience.
Founding Executive Director of The Health Initiative.
Your visit in 3 steps
Request a visit online 24/7 — we confirm your time by email or text.
Request your visit.
Book a visit and choose "Doctor visit". You pay by card when you request it.
See the doctor by video.
We send you a secure video link. It works on your phone, tablet or computer.
Get your plan.
If appropriate, the doctor prescribes and we send your prescription to your pharmacy. If needed, you get a lab order and a doctor’s note.
What a sinus infection visit costs
A sinus infection is handled in a US$79 doctor visit, the same price for every age, with no membership. You pay by card when you request the visit, and you get a full refund if the visit can’t take place. A doctor’s note after your visit is included at no extra charge.
We do not bill insurance; the pharmacy charges separately. See all prices. The service is run by The Health Initiative, a nonprofit.
Sinus infection symptoms
Acute sinusitis often follows a cold that doesn’t get better, or gets worse, after 7 to 10 days. The most common symptoms are:
- Stuffy or runny nose
- Pain or pressure in the face, behind the eyes or in the upper teeth
- Headache
- Mucus dripping down the throat and a sore throat
- Cough, often worse at night
- Bad breath or loss of smell
- Tiredness and sometimes fever
Treatment, and when an antibiotic is needed
The CDC says a bacterial infection is more likely with severe symptoms (bad headache or facial pain), symptoms that get worse after improving, symptoms lasting more than 10 days without improving, or fever lasting more than 3 to 4 days. In those cases the doctor decides whether an antibiotic is appropriate; sometimes it is better to watch for 2 to 3 days before starting one.
When an antibiotic isn’t needed, it doesn’t help and can cause side effects, allergic reactions, antibiotic resistance or a C. difficile gut infection. A sinus infection rarely needs tests; if the doctor thinks one is needed, we give you a lab order. If you get more than 2 or 3 sinus infections a year, or symptoms last more than 12 weeks, she guides you to an ear, nose and throat or allergy specialist.
Home care and prevention
These steps ease congestion and pain while your body fights the infection:
- Put a warm, moist washcloth on your face several times a day.
- Drink plenty of fluids to thin the mucus.
- Breathe in steam, for example in the bathroom with a hot shower running.
- Use saline (salt water) nasal sprays or rinses.
- Decongestant nasal sprays may help at first, but using them for more than 3 days can make congestion worse.
- For pain, acetaminophen or ibuprofen as directed on the label or by your doctor.
- To prevent it: wash your hands, get a flu shot every year, avoid tobacco smoke and keep your allergies under control.
- Puerto Rico’s humidity helps mold grow, and mold can cause congestion and cough in sensitive people: keeping your home dry helps.
Sinus infections in children of all ages
In children, a bacterial sinus infection is more likely when cold symptoms (runny nose, daytime cough) last more than 10 days without improving, when fever and thick nasal discharge last 3 or 4 days, or when a child gets better and then worse again. An ordinary cold usually lasts about 7 days.
The doctor evaluates your child by video with you on camera and, if appropriate, prescribes and we send the prescription to your pharmacy. At home, saline drops and a cool-mist humidifier help a stuffy nose. Never give aspirin to a child, and over-the-counter cough and cold medicines are not recommended under age 4. Patients under 21 need a parent or legal guardian on camera with ID. See our online doctor for kids.
For safety: a baby under 3 months with a temperature of 100.4 °F (38 °C) or higher needs the emergency room right away.
When to go to the ER
Complications are rare, but a sinus infection can spread to the eye or the brain. For your safety, go to the emergency room or call 911 if you notice these signs. See when to go to the ER.
- Swelling or redness around the eye
- Double or blurred vision, or any change in vision
- Severe headache or a stiff neck
- New confusion or unusual drowsiness
- High fever with worsening illness
- A baby under 3 months with a temperature of 100.4 °F (38 °C) or higher
How we care for you
We evaluate, diagnose and treat; if needed, we give you a lab order for a lab near you.
We see adults and children of all ages. Patients under 21: a parent with patria potestad (parental authority) or a legal guardian is on camera for the whole visit and shows photo ID.
Real-time video visit. We send you a secure video link. It works on your phone, tablet or computer.
If appropriate, the doctor prescribes and we send your prescription to your pharmacy. We do not prescribe controlled substances.
You must be physically in Puerto Rico during the visit (visitors, tourists and cruise passengers are welcome).
In an emergency, call 911.
Frequently asked questions
How long does a sinus infection last?
When do I need an antibiotic for a sinus infection?
Can I be treated for a sinus infection by video in Puerto Rico?
Is it allergies or a sinus infection?
About this page
Author: The Health Initiative
Medical care provided by Dr. Diana Nieves Castro, MD (PR license 24027)
Disclosure: Founding Executive Director of The Health Initiative
Published: 2026-09-30 · Updated: 2026-10-02
Sources (5)
- Sinus Infection Basics (CDC) (opens in a new tab) (accessed 2026-09-30)
- Sinusitis (MedlinePlus, NIH) (opens in a new tab) (accessed 2026-09-30)
- The Difference Between Sinusitis and a Cold (AAP, HealthyChildren.org) (opens in a new tab) (accessed 2026-09-30)
- Coughs and Colds: Medicines or Home Remedies? (AAP, HealthyChildren.org) (opens in a new tab) (accessed 2026-09-30)
- Mold and Your Health (CDC) (opens in a new tab) (accessed 2026-09-30)