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A case of localized paranasal sinusitis associated with
Olga Kondratenko1, Artem Lyamin1, Tatiana Savinova2
1Samara State Medical University, Samara, Russia.
Insights
Burkholderia cepacia complex (Bcc) paranasal sinusitis in cystic fibrosis (CF) patients can be treated with surgery. This case study shows prolonged remission of Bcc sinusitis after endoscopic sinus surgery without antibiotics.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Cystic Fibrosis Research
Background:
- Burkholderia cepacia complex (Bcc) infections are a serious concern in cystic fibrosis (CF) patients, often indicating a poor prognosis.
- Paranasal sinusitis caused by Bcc is an uncommon manifestation, especially when it's the sole site of colonization.
Observation:
- A pediatric CF patient presented with paranasal sinusitis exclusively caused by Burkholderia cenocepacia for five years.
- Pulmonary function remained unaffected, with no signs of lung involvement during the period of sinus colonization.
Findings:
- Endoscopic sinus surgery successfully eradicated B. cenocepacia from the paranasal sinuses.
- The patient achieved a prolonged remission of Bcc sinusitis for two years post-surgery, even without antibiotic treatment.
Implications:
- This case highlights the potential for surgical intervention to achieve remission in Bcc-associated paranasal sinusitis.
- It suggests that prolonged remission may be possible without systemic antibiotic therapy following successful sinus surgery in CF patients.
Abstract:
Burkholderia cepacia complex (Bcc) bacteria are considered to be very dangerous players in cystic fibrosis (CF) pathogenesis and are a criterion for negative prognosis in CF cases. In this report, a pediatric case of paranasal sinusitis caused by Burkholderia cenocepacia in a CF patient is described. This is an unusual case, since the paranasal sinuses were the only colonization locus of B. cenocepacia in this patient for 5 years (2015-2020). The lungs remained microbiologically clear with no clinical or radiological signs of pulmonary function decrease during this time period. The paranasal sinuses were sanitized by endoscopic sinus surgery on the left side (2020). Although having no local or systemic antibiotic treatment from the time of surgery to 2022, no B. cenocepacia were detected in the samples. The case shows the possibility of a prolonged remission of Bcc-associated paranasal sinusitis in the absence of systemic antibiotic therapy.
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