Complications of sinusitis in children

Eight patients (6 to 15 years of age) who had periorbital cellulitis and other complications of sinusitis were studied. Both ethmoid and maxillary sinusitis were present in four patients, frontal sinusitis in two, and ethmoid sinusitis and pansinusitis in one patient each. Subdural empyema occurred in four patients, in one case accompanied by cerebritis and brain abscess and in another by meningitis. Periorbital abscess was present in two children who had ethmoiditis. Alveolar abscess in the upper incisors was present in two children whose infection had spread to the maxillary and ethmoid sinuses. Anaerobic bacteria were isolated from the infected sinuses in all the patients. These were seven isolates of Bacteroides sp, four Fusobacterium sp, three microaerophilic streptococci, three Gram-positive anaerobic cocci, and two Veillonella sp. There was only one aerobic isolate recovered, a group F beta-hemolytic. Streptococcus. Surgical drainage and appropriate antimicrobial therapy resulted in complete eradication of the infection in all patients. The role of anaerobic bacteria in sinus infection and its subsequent complication is discussed. Given the possible serious complications of this disease, the early recognition of sinusitis in children and the institution of appropriate antimicrobial and surgical therapy are of great clinical importance.