rhinosinusitis%20-%20acute,%20bacterial%20(pediatric)
RHINOSINUSITIS - ACUTE, BACTERIAL (PEDIATRIC)
Rhinosinusitis is the mucosal inflammation of the nose and paranasal sinuses caused by bacteria lasting >10 days for up to 4 weeks, symptoms resolve completely and may either be persistent or severe.
It is often preceded by a viral upper respiratory tract infection.
Signs & symptoms are nonspecific and it is typically difficult to differentiate from viral upper respiratory tract infection.
Streptococcus pneumoniae is the most common cause followed by nontypeable Haemophilus influenzae.

Specialist Referral

  •  Indications for specialist referral (eg infectious disease specialist, allergologist, or otorhinolaryngologist):
    • Severe infection
    • Recalcitrant infection unresponsive to extended antibiotic therapy
    • Immunocompromised patients with recurrent episodes of rhinosinusitis
    • Presence of comorbidities that may affect treatment response
    • Resistant pathogens
    • Recurrent episodes (3-4x/year) suggesting chronicity of disease with accompanying exacerbations
    • Evaluation of possible anatomical abnormalities causing obstruction that may need surgery
    • Fungal sinus infection or granulomatous disease
    • Nosocomial infection
    • For evaluation of possible immunotherapy for patients with allergic rhinitis
  • Otolaryngology consultation is recommended in moderately to severely ill patients suspected of acute frontal or sphenoid sinusitis because of possible intracranial spread & in patients who do not improve after adequate medical therapy
    • Referral is also needed for possible maxillary sinus aspiration for culture & sensitivity so that therapy may be adjusted correctly
  • Referral to an otolaryngologist &/or ophthalmologist is indicated when signs of impending suppurative complications are present
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS JPOG - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
Rachel Soon, 5 days ago

On 8 August, the first town hall held by the Ministry of Health (MOH) with members of the pharmacy profession took place in Putrajaya. Over 500 pharmacists from across the country and from different areas of practice—community and hospital, public and private, academy and industry—converged to fill the auditorium for the chance to engage in direct dialogue with MOH.

Stephen Padilla, 14 Aug 2019
Early administration of recombinant human B-type natriuretic peptide (rhBNP) can lower the incidence of reperfusion injury for patients with ST-elevation myocardial infarction (STEMI) who are receiving percutaneous coronary intervention (PCI) treatment, according to a China study.
11 Aug 2019
Intraoperative methylprednisolone does not appear to significantly prevent the incidence of death, cardiac arrest and other injuries in neonates undergoing cardiac surgery with cardiopulmonary bypass, according to a recent study.
4 days ago
Pulmonary function has potential predictive value for future increases in arterial stiffness and its progression, as reported in a recent study.