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Clinical and bacteriologic features of chronic sinusitis in children

Article Abstract:

Sinusitis, infection or inflammation of the sinuses, has been recognized increasingly often in children. Different types of bacteria seem to cause acute versus chronic sinusitis. Whereas acute sinusitis organisms are usually aerobic, those causing chronic sinusitis have shown anaerobic isolates, meaning they can grow in the absence of oxygen. In these cases, treatment with antibiotics is not effective and the patients often require surgery. A review of the medical records of 116 children who had surgery for chronic sinusitis was performed; 35 cases met the criteria of complete medical records, sinus X-rays and cultures of the fluid withdrawn from the sinuses. The main symptoms were purulent runny nose, postnasal drip, or both; 14 children had cough, three had wheezing, and 10 had both cough and draining sinuses. All patients underwent irrigation and drainage of their sinuses and were receiving antibiotics at that time. Twenty-nine children also had placement of an antral window, an opening in the sinus, and 10 had adenoidectomy performed as well. Bacteria were isolated in 22 of the 35 cases. All 12 of the children 2 years old and under tested positive for bacterial infection. There were eight cultures positive for streptococcus pneumoniae, and five of these were resistant to penicillin. These findings suggest that difficult to manage, chronic sinusitis in very young children is frequently caused by bacteria. The authors recommend aspiration of fluid from the sinus early in treatment so that the pathogen, or organism causing the infection, can be identified and the appropriate treatment can be initiated. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Case studies, Sinusitis, Paranasal sinuses

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Risk of infectious complications in well-appearing children with transient neutropenia

Article Abstract:

People with chronic neutropenia (low levels of neutrophils, a type of white blood cell) are known to be susceptible to infections, and this is particularly true in children. Risk of infection is correlated with both the duration and the degree of neutropenia. This study evaluated whether children who appear healthy but are incidentally discovered to have neutropenia are at increased risk for infection. The hematology laboratory records for a period of 44 months were reviewed to identify potential subjects; 119 patients met the study criteria of being neutropenic and without serious infection, chronic illness or family history associated with neutropenia. There were 36 children with documented neutropenia lasting more than 30 days, and four of these children developed infections. No infections developed in children who had neutropenia for a shorter duration. There was no association between development of infection and degree of neutropenia. These results suggest that transient neutropenia in otherwise healthy children is not a risk factor for serious infections, but may be associated with minor, infrequent infections if the neutropenia is persistent. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Abnormalities, Complications and side effects, Risk factors, Neutrophils, Neutropenia, Blood cell count

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