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.

Definition

  • Mucosal inflammation of the nose & paranasal sinuses caused by bacteria lasting >10 days for up to 4 weeks symptoms resolve completely & may either be persistent or severe
  • Often preceded by a viral upper respiratory tract infection (URTI)
    • It is a common complication of viral URTI or allergic inflammation

Etiology

  • Streptococcus pneumoniae is the most common cause followed by nontypeable Haemophilus influenzae
  • 3rd most common pathogen is Moraxella catarrhalis
  • Streptococcus pyogenes, respiratory anaerobes, Staphylococcus aureus are less common bacterial causes

Signs and Symptoms

  • Signs & symptoms are nonspecific & it is typically difficult to differentiate from viral upper respiratory infection (URTI)
  • Major symptoms include anterior &/or posterior mucopurulent drainage, nasal obstruction, facial pressure/pain/fullness, hyposmia/anosmia, & fever
  • Less common signs & symptoms include fatigue, headache, ear pressure/discomfort, halitosis, cough, & maxillary dental pain

Risk Factors

  • Most common predisposing factors are viral upper respiratory tract infection (URTI) & allergic inflammation
  • Other predisposing factors
    • Anatomic (eg nasal foreign bodies, septal deviation)
    • Inflammatory [eg gastroesophageal reflux disease (GERD), allergic rhinitis]
    • Systemic (eg cystic fibrosis, immunodeficiencies, primary ciliary dyskinesia)
    • Other factor (eg exposure to cigarette smoking)

 Recent Antibiotic Use

  • Recent antibiotic use (<90 days) is a major risk factor associated w/ increased risk of carriage & infection due to resistant pathogens

Other Risk Factors For Resistant Pathogens

  • Age <2 years
  • Attendance in daycare centers
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