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Updated: Feb 26, 2026

Characterization of Inflammatory Responses During Intranasal Colonization with Streptococcus pneumoniae

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Published on: January 17, 2014

Aggressive necrotizing pseudomonal sinonasal infections.

Edward C Kuan¹, Bobby A Tajudeen², Kevin C Welch³

¹Department of Head and Neck Surgery, University of California, Los Angeles (UCLA), Los Angeles, CA.

International Forum of Allergy & Rhinology

|July 15, 2017

Summary

Pseudomonas aeruginosa can cause severe, necrotizing sinonasal infections, mimicking invasive fungal sinusitis. This case series highlights the aggressive nature of these Pseudomonas aeruginosa infections, especially in immunocompromised individuals.

Keywords:

Pseudomonas immunocompromised infection necrotizing sinusitis

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Area of Science:

Otolaryngology
Infectious Diseases
Bacteriology

Background:

Pseudomonas aeruginosa is a gram-negative bacterium often linked to difficult-to-treat sinonasal infections.
These infections are particularly prevalent in immunocompromised patients.
Aggressive sinonasal infections caused by P. aeruginosa can lead to significant tissue damage.

Observation:

A retrospective review identified 6 patients with rapidly progressive, necrotizing sinonasal infections.
Cultures consistently grew P. aeruginosa without other pathogens.
Patients presented with tissue necrosis resembling invasive fungal sinusitis or malignancy.

Findings:

All 6 patients exhibited tissue necrosis.
Four patients developed cranial nerve palsies, including vision changes and trigeminal neuropathy.
Surgical intervention and antibiotic therapy led to clinical improvement in 4 patients.

Implications:

Pseudomonas aeruginosa can cause severe, necrotizing sinonasal infections that mimic life-threatening conditions.
Early recognition and aggressive management are crucial for patient outcomes.
This study underscores the importance of considering P. aeruginosa in aggressive sinonasal infections.