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.

Patient Education

  • Reassure & educate the patient/parent about the nature of upper respiratory infection (URTI) & acute bacterial rhinosinusitis (ABRS), & expected duration of illness
    • May also inform about the details of therapy, role of antibiotics & bacterial resistance
  • Maintain adequate hydration by drinking 6-10 glasses of water/day to thin the mucus
  • Avoidance of exposure to cigarette smoke
  • Steamy baths: Inhaled steam (from a hot bath/shower) may loosen secretions
  • Apply warm facial packs (eg warm wash cloth, hot water bottle) for 5-10 minutes ≥3x/day to promote drainage of mucus & provide some localized relief
  • Consider nasal sprays, saline irrigation & mist humidification
    • There’s no difference in symptoms score when comparing isotonic w/ hypertonic saline, although hypertonic solutions have been shown to improve mucociliary clearance
    • Provides moisture & reduces symptoms
  • Adequate rest
  • Sleep with head elevated to promote drainage of the sinuses or lay patient on the side to ease breathing

Prevention

  • Appropriate management of allergies & viral URTI (eg frequent handwashing)
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