Acute bacterial rhinosinusitis and its complications in our pediatric otolaryngological department between 1997 and 2006 (original) (raw)
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How to approach complications of acute rhinosinusitis in children?
International Journal of Pediatric Otorhinolaryngology, 2020
Intraorbital and intracranial complications of acute rhinosinusitis (ARS) are uncommon, but potentially life threatening. Signs of progression of ARS should be recognized early to allow timely surgical treatment in order to avoid irreversible lesions such as vision loss and neurological deficits. In this case series, we provide an overview of 6 representative cases who presented at our tertiary center (2017-2018). The aim of this case series is (1) to draw new attention to the clinical manifestations and management of these complications, since even in highly-developed medical settings we still observe permanent sequellae due to delayed or inadequate treatment, (2) to give an updated analysis of the guidelines, stressing the low threshold for endoscopic sinus surgery, even in children, (3) to underline the benefits of a multidisciplinary approach in these young patients.
Intraorbital and Intracranial Complications of Acute Rhinosinusitis: A Rare Case Report
Iranian Journal of Otorhinolaryngology, 2018
Introduction: Complications of acute sinusitis affecting multiple sites are very uncommon in the antibiotic era. However, a significant proportion of patients (5–40%) suffering from acute sinusitis can have these complications mostly due to the delayed diagnosis of the disease. Patients can have variable presentations according to the site and extent of the infection. Case Report: A 21-year-old male student presented with subperiosteal abscess and a brain abscess with a history of acute sinusitis. The patient had short history of left-side hemiplegia with foot drop. Endoscopic orbital decompression was performed and the subperiosteal abscess was drained when it did not respond to medical treatment. Complete clinical and radiological recovery was achieved after 1 month of medical treatment. Conclusion: Complications affecting the multiple sites in acute sinusitis is very uncommon in the antibiotic era. A proper history and thorough clinical examination along with a radiological evalu...
Acute Rhinosinusitis in Children
Acute rhinosinusitis in children is a common disorder that is characterized by some or all of the following symptoms: fever, rhinorrhea, nasal congestion, cough, postnasal drainage, and facial pain/headache. It often starts as an upper respiratory tract infection that is complicated by a bacterial infection in which the symptoms worsen, persist, or are particularly severe. The accurate diagnosis of acute rhinosinusitis is challenging because of the overlap of symptoms with other common diseases, heavy reliance on subjective reporting of symptoms by the parents, and difficulties related to the physical examination of the child. Antibiotics are the mainstay of treatment. There is no strong evidence for the use of ancillary therapy. Orbital and intracranial complications may occur and are best treated early and aggressively. This article reviews the diagnosis, pathophysiology, bacteriology, treatment, and complications of acute rhinosinusitis in children.
Acute bacterial rhinosinusitis in adults: part I. Evaluation
American family physician, 2004
Acute rhinosinusitis is one of the most common conditions that physicians treat in ambulatory practice. Although often caused by viruses, it sometimes is caused by bacteria, a condition that is called acute bacterial rhinosinusitis. The signs and symptoms of acute bacterial rhinosinusitis and prolonged viral upper respiratory infection are similar, which makes accurate clinical diagnosis difficult. Because two thirds of patients with acute bacterial rhinosinusitis improve without antibiotic treatment and most patients with viral upper respiratory infection improve within seven d antibiotic therapy should be reserved for use in patients who have had symptoms for more than seven days and meet clinical criteria. Four signs and symptoms are the most helpful in predicting acute bacterial rhinosinusitis: purulent nasal discharge, maxillary tooth or facial pain (especially unilateral), unilateral maxillary sinus tenderness, and worsening symptoms after initial improvement. Sinus radiograph...
Complications of acute infective rhinosinusitis: experience from a developing country
Singapore medical journal, 2005
Complications of acute infective sinusitis are a therapeutic emergency. The purpose of this study was to determine the clinical presentation, microbiological pattern, treatment modalities and outcome of patients diagnosed to have acute rhinogenic orbital, intra- and extra-cranial complications from a developing country in Asia. A retrospective chart review from October 1999 to January 2004 was conducted. Among 247 ENT surgical emergencies documented, 13 patients (5.3 percent) were diagnosed to have acute sinusitis with various complications either as in solitary or multiple forms. Orbital complications were the most common (61.5 percent) followed by acute subdural empyema (23.1 percent) and meningitis (15.2 percent). Subdural empyema was the most common intracranial complication. Staphylococcus was reported to be the most common offending organism (45.5 percent). Majority of the patients (84.6 percent) had surgical drainage of the affected sinuses, 38.5 percent being endoscopic drai...
Acute and Chronic Rhinosinusitis, Pathophysiology and Treatment
Acute sinusitis (ARS) and chronic rhinosinusitis(CRS) is a common condition worldwide.CRS is due to the infection and inflammation of paranasal sinuses. Frequent clinical manifestations of ARS include persistent symptoms with nasal discharge or cough or both, presentation with fever accompanies purulent nasal discharge, and worsening symptoms. Complications of CRS have five stages, preseptal cellulitis, orbital cellulitis, subperiosteal abscess, orbital abscess and cavernous sinus septic thrombosis. Most acute sinusitis generally of viral origin, e,g. rhinoviruses, corona viruses,and influenza viruses. Bacterial pathogen include Streptococcus pneumonia, Haemophilus influenza and Moraxella catarrhalis. Bacteria found in biofilms have their antibiotic resistant increased up to 1000 times when compared to bacteria free living of same species. Sinusitis also results from fungal invasion in patients with diabetes, immunedeficiencies, and AIDSor transplant patients. Bacterial and viral si...
Clinical Infectious Diseases, 2012
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.
Canadian guidelines for acute bacterial rhinosinusitis: clinical summary
Canadian family physician Médecin de famille canadien, 2014
To provide a clinical summary of the Canadian clinical practice guidelines for acute bacterial rhinosinusitis (ABRS) that includes relevant considerations for family physicians. Guideline authors performed a systematic literature search and drafted recommendations. Recommendations received both strength of evidence and strength of recommendation ratings. Input from external content experts was sought, as was endorsement from Canadian medical societies (Association of Medical Microbiology and Infectious Disease Canada, Canadian Society of Allergy and Clinical Immunology, Canadian Society of Otolaryngology-Head and Neck Surgery, Canadian Association of Emergency Physicians, and the Family Physicians Airways Group of Canada). Diagnosis of ABRS is based on the presence of specific symptoms and their duration; imaging or culture are not needed in uncomplicated cases. Treatment is dependent on symptom severity, with intranasal corticosteroids (INCSs) recommended as monotherapy for mild an...