Sinusitis in children and adolescents

Sinusitis is common in children and adolescents, most frequently as a complication of a viral upper respiratory tract infection or allergic rhinitis. The diagnosis usually is suggested by symptoms of a viral upper respiratory tract infection persisting beyond 10 days without improvement or severe symptoms with fever and purulent rhinitis. Young children frequently do not have the symptoms (headache) or physical findings (sinus tenderness) seen in older patients. Radiographic evaluation may be helpful if the clinical presentation is atypical or severe. Antibiotics remain the primary therapeutic agent of choice in pediatric sinusitis, with other therapeutic modalities having little proven efficacy.