Sinusitis worsened by drinking orange juice every day

Ms. T.T.T.H (49 years old, living in Thủ Đức City) has a history of allergic rhinitis and asthma (which is under control). Recently, she began experiencing unusual symptoms such as prolonged nasal congestion, left ear tinnitus, coughing up greenish-yellow phlegm in the morning, fatigue, and insomnia. Despite taking amoxicillin antibiotics for 10 consecutive days, her condition did not improve.

Ms. H. then went to the doctor to find the cause. After a clinical examination, endoscopy of the ear, nose, and throat, and a CT scan of the sinuses, the doctor initially diagnosed her with poly-sinusitis, with the right maxillary sinus suspected of fungal infection.

Dr. Trần Minh Dũng, an ENT specialist at MEDLATEC Gò Vấp Clinic, who directly examined the patient, said, “Sinusitis suspected to be caused by fungus needs to be clearly differentiated from regular sinusitis because the treatment methods are completely different. If treated incorrectly, such as using local corticosteroids as with regular sinusitis, the condition can worsen.”

Next, the doctor prescribed additional specialized microbiological tests such as fungal smear and bacterial culture from sinus secretions. Fortunately, the results showed no fungal infection. However, the sinus sample revealed Staphylococcus bacteria, which is the cause of the infection. Therefore, Ms. H. was diagnosed with bacterial sinusitis of the right maxillary sinus, not fungal sinusitis.

Additionally, the examination results showed that she had chronic sinusitis in the acute phase, nasal polyps, and right-side otitis media, which was the cause of her tinnitus.

What was surprising is that one of the contributing factors to the prolonged inflammation was her habit of drinking orange juice and lemon juice every day. The allergy panel test revealed that Ms. H. is allergic to oranges and lemons—two foods that can trigger an inflammatory response through IgE-mediated mechanisms, directly affecting the mucous membranes of the sinuses when consumed frequently.

"Many people think that supplementing vitamin C through orange or lemon juice is good, but if the body is allergic to these foods and you don't know it, frequent consumption can make allergic sinusitis worse," Dr. Dũng warned.

According to Dr. Dũng, self-administering prolonged antibiotics can also lead to antibiotic resistance, making it more difficult to treat the condition later.

Combining multiple methods for effective treatment

With the combination of clinical examination, ear, nose, and throat endoscopy, CT sinus scans, allergy testing, and microbiological techniques, the doctor was able to pinpoint the exact cause and adjust the treatment plan accordingly.

After removing the allergen and following the proper treatment, Ms. H.'s symptoms improved significantly: her ear tinnitus, nasal congestion, phlegm production, and sleep quality all improved.

“If you frequently experience nasal congestion, ear tinnitus, coughing up phlegm in the morning, runny nose, or insomnia due to respiratory symptoms, don’t be complacent. Self-diagnosis and self-treatment not only fail to be effective but also pose risks. Please visit a doctor and undergo thorough testing to get an accurate diagnosis,” Dr. Dũng advised.