Nosocomial sinusitis: a unique subset of sinusitis

Area of Science:

• Critical care medicine
• Infectious diseases
• Otolaryngology

Background:

• Nosocomial sinusitis is an underrecognized complication in critically ill patients, often presenting with non-specific signs of fever and infection.
• Risk factors include nasal/oral intubation, facial trauma, immobility, and pre-existing sinus disease, frequently occurring in intensive care unit settings.

Purpose of the Study:

• To review the current understanding of nosocomial sinusitis.
• To highlight diagnostic challenges, potential complications, and effective treatment strategies.

Main Methods:

• Literature review focusing on recent citations regarding nosocomial sinusitis.
• Analysis of diagnostic modalities, including radiography and computed tomography (CT) scans.
• Examination of microbiological data and treatment protocols.

Main Results:

• Common inciting factors are nasal and oral tubes; patients often present with subtle signs in the ICU.
• Complications include sepsis, bloodstream infections, and direct extension to the brain and lungs.
• Microbiology differs from community-acquired sinusitis, with frequent isolation of Staphylococcus spp. and Pseudomonas spp.

Conclusions:

• Nosocomial sinusitis remains a significant cause of morbidity and mortality in critically ill patients.
• Prompt identification and targeted treatment, including antibiotic therapy and removal of inciting devices, can improve outcomes.
• Addressing nosocomial sinusitis may reduce overall nosocomial infections and associated patient harm.