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Childhood epistaxis and nasal colonization with Staphylococcus aureus
Andrew D Whymark1, David P Crampsey, Lyndsay Fraser
1Institution Department of Paediatric Otolaryngology, Head and Neck Surgery, Royal Hospital for Sick Children, Yorkhill, Glasgow, UK.
Objective:
Epistaxis is very common in children but its cause remains unknown. We postulate that nasal colonization with Staphylococcus aureus leads to inflammation, crusting, and ultimately new vessel formation.
Study Design:
A prospective case-control study.
Subjects And Methods:
Sixty-seven children were recruited, 42 with epistaxis (22 had crusting in the nasal vestibule; 20 did not) and 25 control subjects. A microbiology swab was taken from the anterior nasal cavity of each child.
Results:
All groups were equally likely to have a positive culture. S aureus was more common in the epistaxis group (P = 0.008) compared with the control group. There was no difference in the prevalence of S aureus between crust and noncrust groups. Epistaxis patients were much less likely to have isolates of respiratory pathogens or a skin commensal.
Conclusion:
Children with epistaxis are more likely to have nasal colonization with S aureus than controls. Our data would support the hypothesis that S aureus replaces existing nasal flora and causes inflammation and new vessel formation.
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