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)
  • There’s anterior &/or posterior mucopurulent drainage, &
    • Nasal obstruction, or
    • Facial pressure/pain/fullness
  • Accompanied by less common signs & symptoms (eg fatigue, headache, ear pressure/discomfort, throat pain, hyposmia/anosmia, maxillary dental pain, facial swelling or periorbital edema)

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
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS JPOG - Malaysia digital copy today!
DOWNLOAD
Editor's Recommendations
Most Read Articles
09 Apr 2016
Among adolescents who have only received diphtheria, tetanus toxoids, acellular pertussis (DTaP) vaccines in childhood, tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine provides moderate protection against pertussis during the first year and then wanes rapidly thereafter.
26 Jul 2007
Despite the prevalence of corticosteroid use in infants with bronchiolitis, data on its efficacy is insufficient. In this study, oral dexamethasone was compared with placebo in the treatment of bronchiolitis.