Sinusitis in paediatrics

The authors discuss the problem of the diagnosis of sinusitis in children from the viewpoint of the practising paediatrician, on the basis of 106 children and adolescents aged between 6 and 17 years, and suffering from sinusitis. Maxillary sinusitis (56.5%) and a combination of maxillary and ethmoidal sinusitis (24.5%) were commonest, and pan-sinusitis occurred in about 10% of cases. The commonest complaints in the history were cough, headache, pyrexia and rhinitis. The commonest clinical findings were pharyngitis, retropharyngeal drip, tenderness to pressure over the sinus points, otitis media, a deterioration in the general condition, enlarged tender angular lymph nodes, bronchitis and rhinitis. The result of treatment of sinusitis in childhood with the antibiotic used here, doxycycline, are assessed. A successful result was obtained in 94.3% of cases; cure in 77 patients (72.6%) and marked improvement in 23 (21.7%). There were six failures (5.7%). In the majority of children - 72 cases (68%), the duration of treatment was 15-21 days. It was 10-14 days in 18 children (17%) and more than 3 weeks in 16 children (15%). Rapid subjective improvement was seen in 65 cases (61.3%), and rapid objective improvement in 80 (75.5%). The tolerance of doxycycline was very good in nearly all patients. Mild symptoms of gastrointestinal intolerance were seen in two cases.