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Pediatric atrophic rhinosinusitis: what can we do?
Clara Magalhães1, Miguel Viana1, Valquíria Alves2
1Department of Otolaryngology, Pedro Hispano Hospital, Matosinhos, Portugal.
International Journal of Pediatric Otorhinolaryngology
|March 24, 2015
Summary
Chronic foul-smelling nasal discharge in a child was diagnosed as atrophic rhinosinusitis caused by Klebsiella ozaenae. Long-term antibiotic prophylaxis with sulfamethoxazole-trimethoprim led to complete clinical improvement.
Area of Science:
- Otorhinolaryngology
- Microbiology
- Pharmacology
Background:
- Atrophic rhinosinusitis is a chronic nasal condition characterized by nasal obstruction, crusting, and foul odor.
- Primary atrophic rhinosinusitis, often linked to specific bacterial pathogens, presents diagnostic and therapeutic challenges.
Observation:
- A 5-year-old female presented with chronic, foul-smelling nasal discharge and significant nasal crusting.
- Rhinoscopy revealed shriveled inferior turbinates and greenish crusts within the nasal cavities.
Findings:
- Nasal cultures identified Klebsiella ozaenae as the causative agent, confirming primary atrophic rhinosinusitis.
- Initial treatments were unsuccessful; however, a year of sulfamethoxazole-trimethoprim prophylaxis resulted in complete clinical resolution.
Implications:
- Antibiotic prophylaxis offers a promising long-term management strategy for atrophic rhinosinusitis, particularly when other treatments fail.
- This case highlights the potential of targeted antimicrobial prophylaxis in managing chronic, refractory sinonasal infections.
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