After 20 years of sinus infections, 2 surgeries, and 2 months of IVs for sinus infections, I can now say unequivocally, that unless there is pus, there's not necessarily a sinus infection.

Face pain and stuffiness can be caused by myofascial disorders, and I am now getting treatment for pain that feels like sinus pain by osteopathic neck massage and acupuncture. My ENT says that I'm not infected, though I get inflamed. But then, when nerve fibers are impinged upon, they send pain signals out and can hurt in places other than the starting point.

So, unless there's clinical evidence of infection....think pain syndrome. It might lead someplace interesting.

For me, it lead to lyme disease, which causes a both neuropathy and myofascial pain. The mycobacterium and fungi were red herrings.