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Subacute sinusitis in children
1Department of Pediatrics, University of Pittsburgh School of Medicine, Children's Hospital, PA 15213.
Insights
Subacute maxillary sinusitis in children is often caused by common bacteria like Streptococcus pneumoniae. Findings in children are similar to acute sinusitis, with nasal discharge and cough being key symptoms.
Area of Science:
- Pediatric Otolaryngology
- Infectious Diseases
- Microbiology
Background:
- Subacute maxillary sinusitis in children lacks detailed bacteriologic characterization.
- Understanding causative agents is crucial for effective pediatric respiratory infection management.
Purpose of the Study:
- To delineate the bacteriologic characteristics of subacute maxillary sinusitis in children aged 2-12 years.
- To compare pediatric subacute maxillary sinusitis with acute forms.
Main Methods:
- Evaluated 40 children (2-12 years) with prolonged respiratory symptoms (30-120 days).
- Collected sinus aspirates from 52 maxillary sinuses for bacterial culture and colony counts.
- Assessed clinical presentation and radiographic findings.
Main Results:
- Common symptoms included nasal discharge and cough; radiographic findings showed opacification and mucosal thickening.
- Bacterial pathogens, primarily Streptococcus pneumoniae, Haemophilus influenzae, and Branhamella catarrhalis, were identified in 65% of children.
- High bacterial loads (≥10^4 CFU/mL) were found in 58% of aspirates.
- Twenty-five percent of isolates were beta-lactamase producing, some from patients on prior antibiotics.
Conclusions:
- Subacute maxillary sinusitis in children shares similar causative organisms, clinical presentation, and radiographic findings with acute maxillary sinusitis.
- This study provides essential bacteriologic data for pediatric subacute sinusitis.
- Findings support the similarity between acute and subacute presentations in this age group.
Abstract:
The bacteriologic characteristics of subacute maxillary sinusitis have not been delineated in the pediatric age group. Forty children between the ages of 2 and 12 years with respiratory symptoms for at least 30 but less than 120 days were evaluated. Nasal discharge and cough were the most prominent symptoms. Common radiographic findings were diffuse opacification and mucosal thickenings. Sinus aspiration was performed on 52 sinuses of 40 children. Bacterial colony counts greater than or equal to 10(4) colony-forming units per milliliter were found in 30 (58%) of 52 sinus aspirates obtained from 26 (65%) children. The bacterial species most commonly recovered were Streptococcus pneumoniae, Haemophilus influenzae, and Branhamella catarrhalis. Twenty-five percent of the maxillary sinus isolates were beta-lactamase producing; however, many of these were recovered from patients who had recently received antimicrobial therapy. Subacute and acute maxillary sinusitis are similar in regard to causative organism, clinical presentation, and radiographic findings.