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Related Experiment Videos

Nosocomial sinusitis

E S Caplan, N J Hoyt

    JAMA
    |February 5, 1982
    PubMed
    Summary
    This summary is machine-generated.

    Nosocomial sinusitis, an infection acquired in hospitals, frequently occurs in severely injured patients with nasopharyngeal tubes. Prompt diagnosis and treatment are crucial for patient recovery and preventing complications.

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    Area of Science:

    • Infectious Diseases
    • Critical Care Medicine
    • Otolaryngology

    Background:

    • Nosocomial infections pose a significant threat in intensive care settings.
    • Nasopharyngeal instrumentation is common in severely traumatized patients.
    • Sinusitis can be a challenging diagnosis in critically ill patients.

    Purpose of the Study:

    • To identify the incidence and characteristics of nosocomial sinusitis in severely traumatized patients.
    • To determine common pathogens and predisposing factors for this infection.
    • To evaluate treatment outcomes and emphasize the importance of early diagnosis.

    Main Methods:

    • A 24-month retrospective review of 32 severely traumatized patients with nasopharyngeal instrumentation.
    • Diagnosis based on radiographic evidence of sinusitis and purulent sinus aspirates or nasal discharge.

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  • Microbiological analysis of sinus aspirates to identify causative pathogens.

    • Main Results:

    • 34 cases of nosocomial sinusitis were identified, representing 5% of all nosocomial infections.
    • Predisposing factors included nasotracheal/nasogastric tubes, nasal packing, corticosteroids, and fractures.
    • Gram-negative bacilli were the most common pathogens; 14 infections were polymicrobic.
    • Clinical resolution occurred in 20 patients after treatment and tube removal; 7 had persistent radiological abnormalities.

    Conclusions:

    • Nasopharyngeal instrumentation is a significant risk factor for nosocomial sinusitis in trauma patients.
    • Fever and leukocytosis in patients with indwelling nasal tubes warrant investigation for sinusitis.
    • Early diagnosis and management are essential to improve outcomes and reduce morbidity.