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Published on: February 9, 2011

Incidental sinusitis in a pediatric intensive care unit

Brooke M Moore1, Karen Blumberg, Theresa A Laguna

  • 1Division of Pediatric Pulmonology, Department of Pediatrics, University of Minnesota School of Medicine and Amplatz Children's Hospital, Minneapolis, MN, USA.

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
|February 2, 2011
PubMed

Insights

Nosocomial sinusitis is common in pediatric intensive care unit patients, with nearly half showing evidence of the condition. This highlights the need to consider sinusitis in diagnosing fever in these vulnerable children.

Area of Science:

  • Pediatric critical care medicine
  • Infectious diseases
  • Radiology

Background:

  • Nosocomial sinusitis is a known complication in adult intensive care units.
  • Sinusitis can be an unrecognized cause of fever in intubated patients.
  • The frequency of sinusitis in pediatric intensive care units (PICUs) remains understudied.

Purpose of the Study:

  • To determine the incidental frequency of sinusitis in PICU patients compared to non-PICU patients.
  • To assess if the presence of tubes (nasotracheal, nasogastric, orotracheal, or orogastric) increases sinusitis risk in PICU patients.
  • To investigate if nasal tubes pose a higher sinusitis risk than oral tubes.

Main Methods:

  • Retrospective chart review at a pediatric healthcare system.
  • Analysis of head computed tomography (CT) scans in PICU and non-PICU patients.
  • Sinusitis defined as Lund-MacKay score ≥5.

Main Results:

  • 44.3% of PICU patients had sinusitis vs. 26.9% of non-PICU patients (p < .001).
  • 69.4% of PICU patients with tubes had sinusitis vs. 29.4% without tubes (p < .001).
  • Younger age and presence of a tube increased sinusitis probability (p < .001).

Conclusions:

  • Nearly half of PICU patients undergoing head CTs showed incidental sinusitis.
  • Over half of PICU patients with sinusitis were febrile within 48 hours of imaging.
  • Sinusitis is common in PICU patients and should be considered in fever differential diagnoses.
Abstract

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