Do simple laboratory tests help in etiologic diagnosis in acute maxillary sinusitis?

Area of Science:

• Otolaryngology
• Infectious Diseases
• Clinical Pathology

Background:

• Acute maxillary sinusitis (AMS) is a common condition.
• Identifying the causative agent is crucial for effective treatment.
• Hematologic markers are often used to assess inflammation.

Purpose of the Study:

• To evaluate the utility of erythrocyte sedimentation rate (ESR), white blood cell count (WBC), and C-reactive protein (CRP) in identifying the etiology of AMS.
• To determine if routine hematologic tests can differentiate bacterial from viral sinusitis.

Main Methods:

• Retrospective analysis of 176 patients diagnosed with AMS.
• Correlation of hematologic test results (ESR, WBC, CRP) with microbiological culture findings.
• Analysis of common bacterial pathogens including Streptococcus pyogenes, Streptococcus pneumoniae, Haemophilus influenzae, and Branhamella catarrhalis.

Main Results:

• 82% of patients had normal ESR, WBC, and CRP values.
• Culture-negative results were observed in 22% of cases.
• Elevated CRP levels were associated with Streptococcus pyogenes and Streptococcus pneumoniae.
• Haemophilus influenzae and Branhamella catarrhalis positive AMS were indistinguishable from viral sinusitis using these tests.

Conclusions:

• Routine hematologic tests (ESR, WBC, CRP) lack sensitivity for determining the specific etiology of AMS.
• Elevated CRP (> 40 mg/l) may indicate Streptococcus pyogenes or Streptococcus pneumoniae, warranting closer monitoring due to risk of complications.
• These tests cannot differentiate bacterial AMS caused by Haemophilus influenzae or Branhamella catarrhalis from viral sinusitis.