[Acute ethmoiditis in children, a series of 125 cases]

Acute ethmoiditis are bacterial infections of ethmoid sinuses, which may spread to the orbital or the endocranial spaces. It is essential to fit the antibiotherapy to the bacteria responsible for these infections.

The charts of children hospitalized from 1995 to 2003 for an acute ethmoiditis were reviewed, particularly the results of bacterial exams and the antibiotics delivered.

Over this 9-year period, 125 children (mean age 4.5 years) were hospitalized for acute ethmoiditis. Eighty were checked for blood cultures, which were sterile in 73 cases, and in the other cases, grew Staphylococcus, S. Pneumoniae or Streptococcus pyogenes. Seric soluble antigens were absent in the 5 cases where they were looked for. Ten children had a puncture of a subperiostal abscess: it was sterile in 5 cases, Staphylococcus was found in 4 cases, S. pneumoniae in the last case. Most children received an association of cefotaxim and fosfomycine for a mean duration of 5.6 days. Thirteen per cent of the children received 3 or 4 antibiotics.

It is always difficult to found the bacteria responsible for an acute ethmoiditis. In our serie as in others, the most frequent bacteria were Staphylococcus, S. pneumoniae and S. pyogenes.

In view of the bacteria responsible for these infections and their antibiotic resistance, we suggest the association of cefotaxim and fosfomycin for the first line of treatment of acute ethmoiditis.