Bacterial Rhinosinusitis In Children Research Articles

Complications to acute bacterial rhinosinusitis in children - a prospective study; bacterial cultures, virus detection, allergy sensitization and immunoglobulins.

Prospective studies of complications due to acute rhinosinusitis are lacking, bacterial cultures are hard to obtain and the role of airborne allergies, viruses and immunoglobulin levels are unclear. The aim was to investigate the role of bacteria, viruses, allergy and immunoglobulins in children hospitalized due to rhinosinusitis. A prospective cohort study in Stockholm, Sweden, of children up to 18 years of age, hospitalized due to acute bacterial rhinosinusitis, from April 1st, 2017 to April 1st, 2020. Of 55 children included, 51% had a positive viral nasopharyngeal PCR and 29% had a positive allergy sensitization test. A higher percentage of middle meatus cultures were positive for bacterial growth compared to nasopharyngeal and displayed a wider array of bacteria. Dominating bacteria were S. milleri in surgical (7/12 cases), S. pyogenes in middle meatus (13/52 cases), and S. pyogenes and H. influenza in nasopharyngeal cultures (8/50 cases respectively). Nasal cultures were negative in 50% of surgical cases. An association was found between S. pyogenes and peak CRP; H. influenzae and peak CRP; S. pneumoniae and peak CRP; and possibly between M. catarrhalis and days of IV antibiotics. Further, an association between influenza A/B and S. pyogenes; a positive viral PCR and lower grade of complication and peak CRP; and a possible association between influenza virus and lower grade of complication. Allergy sensitization was possibly associated with a higher number of days with IV antibiotics. No immunoglobulin deficiencies were found. There seem to be differences in the patterns of bacterial growth in nasopharyngeal, middle meatus and surgical cultures in children with complications to acute bacterial rhinosinusitis. Presence of certain viruses and sensitization to airborne allergies seem to play a role in complications to acute bacterial rhinosinusitis in children.

Complications of Acute Bacterial Rhinosinusitis in Children: A Single Tertiary Care Center

Complications of Acute Bacterial Rhinosinusitis in Children: A Single Tertiary Care Center

Low-frequency ultrasound in the treatment of acute bacterial rhinosinusitis in children

Low-frequency ultrasound in the treatment of acute bacterial rhinosinusitis in children

National burden of antibiotic use for adult rhinosinusitis

National burden of antibiotic use for adult rhinosinusitis

Bacterial rhinosinusitis in children: microbiology and resistance pattern

Bacterial rhinosinusitis in children: microbiology and resistance pattern

TOPICAL ANTIBACTERIAL AGENTS IN ACUTE BACTERIAL RHINOSINUSITIS IN INFANTS AT THE AGE UNDER ONE YEAR

The data on acute bacterial rhinosinusitis in children at the age under 1 year of life as one of the most difficult for diagnostics and treatment disorder are shown in this article. One of the main methods of treatment of this disease is usage of antibacterial agents — both systemic and topical. However choice of such drugs is complicated due to the age limits. Topical nasal spray with wide spectrum of bactericidal activity can be indicated in patients since birth. It significantly increases the efficacy of treatment and decreases the risk of complications. That is why it can be recommended for acute rhinosinusitis treatment in children of such age group.

Highlights From the Infectious Diseases Society of America Clinical Practice Guideline for Acute Bacterial Rhinosinusitis in Children and Adults

This represents the first clinical practice guideline on the topic of acute bacterial sinusitis that has been published by the Infectious Diseases Society of America. Recommendations include use of amoxicillin/clavulanate as first-line therapy for adults or children and a short duration of therapy for adults (5–7 days). Intranasal saline irrigation is recommended as an adjunctive therapy, whereas the use of decongestants/antihistamines is not recommended.

IDSA Clinical Practice Guideline for Acute Bacterial Rhinosinusitis in Children and Adults

AbstractEvidence-based guidelines for the diagnosis and initial management of suspected acute bacterial rhinosinusitis in adults and children were prepared by a multidisciplinary expert panel of the Infectious Diseases Society of America comprising clinicians and investigators representing internal medicine, pediatrics, emergency medicine, otolaryngology, public health, epidemiology, and adult and pediatric infectious disease specialties. Recommendations for diagnosis, laboratory investigation, and empiric antimicrobial and adjunctive therapy were developed.

Executive Summary: IDSA Clinical Practice Guideline for Acute Bacterial Rhinosinusitis in Children and Adults

Evidence-based guidelines for the diagnosis and initial management of suspected acute bacterial rhinosinusitis in adults and children were prepared by a multidisciplinary expert panel of the Infectious Diseases Society of America comprising clinicians and investigators representing internal medicine, pediatrics, emergency medicine, otolaryngology, public health, epidemiology, and adult and pediatric infectious disease specialties. Recommendations for diagnosis, laboratory investigation, and empiric antimicrobial and adjunctive therapy were developed.

Complications of Bacterial Rhinosinusitis in Children and their Management

Sinus infection can spread through anastomosing veins or by direct extension to close by structures. Orbital complications of rhinosinusitis were categorized by Chandler et al. [2] into five stages according to their severity. Contiguous spread to the oribital area can cause periorbital cellulitis, subperiosteal abscess, orbital cellulitis, and abscess. Orbital cellulitis can complicate acute ethmoiditis if thrombophlebitis of the anterior and posterior ethmoidal veins spreads to the lateral or orbital side of the ethmoid labyrinth. Sinusitis can also spread intracranially, where it can cause cavernous sinus thrombosis, retrograde meningitis, and epidural, subdural, and brain abscesses [2-5]. Orbital symptoms often precede intracranial extension of the infection [5]. Other complications include sinobronchitis, maxillary osteomyelitis, and frontal bone osteomyelitis [6-10]. Frontal bone osteomyelitis often originates from an extending thrombophlebitis. Frontal sinus periostitis can cause outer membrane osteitis and periostitis, which produces a tender, puffy swelling of the forehead. The most common pathogens causing these complications are those seen in acute and chronic rhinosinusitis, depending on the length and etiology of the primary rhinosinusitis. These include Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcos aureus (including methicillin resistant), anaerobic bacteria (Prevotella, Porphyromonas, Fusobacterium and Peptostreptococcus spp.) and Microaerophilic streptococci [5]. Anaerobic bacteria are mostly found in chronic rhinosinusitis and those associated with dental etiology [11]. Early diagnosis of a complication is of prime importance. Diagnosis is assisted by computed tomography (CT) and nuclear isotope scanning. Prevention of these complications is of great importance. This can be accomplished by administering appropriate empiric antimicrobial therapy, obtaining sinus cultures from those who fail to respond to treatment after 2-4 days and those with severe symptoms who do not respond within 48 hours, and the immunocompromised. These cultures

From clinical practice to guidelines: how to recognize rhinosinusitis in children

Rhinosinusitis is a common childhood respiratory infection. Children have approximately six to eight viral infections of the upper respiratory tract each year, 5-13% of which may be complicated by a secondary bacterial infection of the paranasal sinuses. The diagnosis of acute bacterial rhinosinusitis in children is established by the persistence of purulent nasal or post-nasal draining lasting at least 10 days, especially if accompanied by supporting symptoms and signs, at which point antibiotic treatment has to be recommended. Appropriate antibacterial therapy should also be recommended if the draining has been present for less time, but is concomitantly associated with significant fever and localized signs of sinus inflammation in a child who appears ill. Imaging studies are not necessary to confirm the diagnosis of clinical rhinosinusitis for the purposes of treatment, but should be reserved for cases in which the diagnosis is in doubt or a complication is suspected, and for patients with recurrent or chronic rhinosinusitis. Under these circumstances, computed tomography is the preferred evaluation. Together with their clinical judgment, these suggestions may be useful for pediatricians in diagnosing this common condition.

Rhinosinusitis in children

Clinical practice guidelines for the management of acute bacterial rhinosinusitis in children were published by the American Academy of Pediatrics in 2001. Changes in the antibiotic susceptibility patterns for the common pathogens causing both acute and chronic rhinosinusitis warrant a reevaluation and update of these recommendations. In addition, there was only a very brief discussion of chronic disease in this publication, with the conclusion that the pathogenesis and management of recurrent or prolonged infection were essentially unknown. Although there are still insufficient data in the literature to develop evidence-based clinical guidelines, a careful review of recent literature and the clinical experience of experts who manage pediatric chronic sinusitis are presented in an effort to provide some specific recommendations and to offer practical treatment options. Factors associated with chronic rhinosinusitis should be addressed individually and include environmental pollution, recurrent viral upper respiratory infections, allergic and nonallergic rhinitis, ciliary dyskinesia, cystic fibrosis, immunodeficiency, gastroesophageal reflux, and anatomic abnormalities.

Management of acute bacterial rhinosinusitis.

Acute bacterial rhinosinusitis is an infection of the nasal epithelium and paranasal sinus mucosa, usually caused in children by Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, and, less frequently, group A Streptococcus species. The clinical diagnosis is based on daytime cough that may be worse at night or purulent rhinorrhea, or both, lasting at least 10 days, often worsening after a period of initial improvement after initial symptoms of the common cold, and often associated with facial or dental pain, facial fullness, or swelling, headache, and fever. Sinusitis is diagnosed clinically; radiographic evaluation is not indicated for diagnosis. When the disease persists despite treatment, or is complicated by potential intracranial or orbital extension, CT is the preferred imaging modality. Initial therapy should be amoxicillin in a high dosage (80-90 mg/kg/day). Treatment is generally for 10 to 14 days and for at least 7 days beyond the time of substantial improvement in symptoms. Complications of acute bacterial rhinosinusitis in children are rare.

Antimicrobial guidelines for the treatment of acute bacterial rhinosinusitis in immunocompetent children

Acute rhinosinusitis represents a condition for which educational efforts could help minimize the inappropriate use of antibiotics, particularly for children. The majority of acute rhinosinusitis cases are of viral etiology and thus, are self limiting. Although bacterial infection complicates a small number of cases, the lack of accessibility to the sinus, the limitations of diagnostic modalities and the lack of specificity among signs and symptoms often make it difficult to determine when bacterial infection occurs. Furthermore, antimicrobial resistance among the pathogens that frequently cause bacterial infection complicates the election of empiric therapy. The Sinus and Allergy Health Partnership recently developed and published antimicrobial guidelines to provide practitioners in the US with recommendations for the diagnosis and treatment of acute bacterial rhinosinusitis. The purpose of this paper is to review the rationale behind the development of these guidelines and how they apply to the management of acute bacterial rhinosinusitis in children.