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 15,372 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This review summarizes the recent literature published on the microbiology, diagnosis, and medical and surgical management of acute and chronic frontal sinus disease. Two retrospective studies investigated the microbiology of frontal sinusitis in patients that underwent sinus surgery. Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus predominated in acute infection in patients with acute frontal sinusitis, and S. aureus and anaerobic bacteria were commonly isolated in chronic sinusitis. Surgery is indicated to treat patients with acute and chronic sinusitis and their complications. Several surgical procedures were recently evaluated, and these are briefly reviewed.
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PMID:Acute and chronic frontal sinusitis. 1268 60

We studied the bacteriology of maxillary sinus aspirates obtained from patients diagnosed with chronic sinusitis. We recovered 659 strains from 510 aspirates; of these, 572 (86.8%) were aerobes and 87 (13.2%) were anaerobes. Aerobes only were recovered from 310 of the 510 specimens (60.8%) and anaerobes only from 31 (6.1%). Among the 572 aerobic bacteria, the most prevalent organisms were Streptococcus viridans (158 strains [27.6%]), Streptococcus pneumoniae (67 [11.7%]), Corynebacterium species (66 [11.5%]), Staphylococcus aureus (54 [9.4%]), Moraxella catarrhalis (38 [6.6%]), Hemophilus parainfluenzae (33 [5.8%]), and group C beta-hemolytic streptococci (26 [4.5%]). Among the 87 recovered anaerobes were species of Peptostreptococcus (32 strains [36.8%]), Prevotella (22 [25.3%]), Actinomyces (13 [14.9%]), Propionibacterium (11 [12.6%]), Fusobacterium (8 [9.2%]), and Veillonella (1 [1.1%]). Beta-lactamase production was detected in 115 of the 572 aerobic strains (20.1%) and in 10 of the 87 anaerobic strains (11.5%). We found that the prevalence and type of organisms we identified in chronic sinusitis did not differ substantially from those reported in previous studies. Our study is one of the more extensive reports on the type and prevalence of pathogens in chronic sinusitis that has been published to date.
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PMID:Bacteriologic findings in patients with chronic sinusitis. 1460 78

The bacterial flora taken by sinus puncture from 115 patients with uni and bilateral acute exacerbation of chronic maxillary sinusitis was analyzed. Germ-free culture was obtained in 49 cases (40%) and in 69 cases (60%) bacteria were isolated from all sinus aspirates. Microbiological evaluation shows, that in majority of cases (90%) of acute exacerbation of chronic sinusitis there were pathogenic bacteria namely aerobic and anaerobic. The most frequent pathogens isolated from the aspirates were; Staphylococcus aureus, Haemophilus influenzae, Escherichia coli, Streptococcus pneumoniae, Staphylococcus hominis, Propionibacterium acnes i Candida albicans. The culture analysis proves that one or more pathogens can be the etiological factor. In the majority of cases (64%) the sinusitis is caused by monoculture.
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PMID:[Microbiology of acute exacerbation chronic sinusitis in adults]. 1530 80

Although most cases of acute rhinosinusitis are caused by viruses, acute bacterial rhinosinusitis is a fairly common complication. Even though most patients with acute rhinosinusitis recover promptly without it, antibiotic therapy should be considered in patients with prolonged or more severe symptoms. To avoid the emergence and spread of antibiotic-resistant bacteria, narrow-spectrum antibiotics such as amoxicillin should be used for 10 to 14 days. In patients with mild disease who have beta-lactam allergy, trimethoprim/sulfamethoxazole or doxycycline are options. Second-line antibiotics should be considered if the patient has moderate disease, recent antibiotic use (past six weeks), or no response to treatment within 72 hours. Amoxicillin-clavulanate potassium and fluoroquinolones have the best coverage for Haemophilus influenzae and Streptococcus pneumoniae. In patients with beta-lactam hypersensitivity who have moderate disease, a fluoroquinolone should be prescribed. The evidence supporting the use of ancillary treatments is limited. Decongestants often are recommended, and there is some evidence to support their use, although topical decongestants should not be used for more than three days to avoid rebound congestion. Topical ipratropium and the sedating antihistamines have anticholinergic effects that maybe beneficial, but there are no clinical studies supporting this possibility. Nasal irrigation with hypertonic and normal saline has been beneficial in chronic sinusitis and has no serious adverse effects. Nasal corticosteroids also may be beneficial in treating chronic sinusitis. Mist, zinc salt lozenges, echinacea extract, and vitamin C have no proven benefit in the treatment of acute bacterial rhinosinusitis.
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PMID:Acute bacterial rhinosinusitis in adults: part II. Treatment. 1630 28

This review examines the issues surrounding short-course antibiotic therapy of acute sinusitis. Acute bacterial sinusitis is a common community-acquired infection defined as inflammation of one or more paranasal sinuses, most often the maxillary sinus. It is estimated that 0.5-5% of colds are complicated by acute sinusitis. Up to 1 in 20 upper respiratory tract infections is complicated by bacterial sinusitis, most often caused by Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis and Staphylococcus aureus. Early diagnosis and appropriate antibiotic therapy, in combination with agents that relieve nasal congestion, are important factors in preventing suppurative complications. Left untreated, it could lead to the development of chronic sinusitis or epidural or subdural empyema, brain abscess, or cavernosus sinus thrombosis. Isolation of the causal organism is often lacking in the community setting. Empiric antibiotic therapy should provide adequate coverage against the most important pathogens. Guidelines from different specialist societies based on current scientific knowledge are helpful in making the decision on which drug to use. Recommendations for duration of treatment of acute sinusitis are inconsistent between different guidelines but usually a 10- to 14-day treatment course is recommended.Recognition that the 10- to 14-day duration of therapy is not derived from a strong scientific or medical rationale has led some clinicians to call for shortening the duration of antibiotic therapy for patients with upper respiratory tract infections. Accumulating evidence suggests that short-course (< or =5 days) antibiotic therapy may have equivalent or superior efficacy compared with traditional longer (10-14 days) therapies and offers a number of advantages. Results of a number of clinical trials investigating 5-day therapy with oral cephalosporins, new quinolones or ketolides in acute (presumed) bacterial sinusitis in comparison with traditional 10-day treatment courses have been published demonstrating equivalent efficacy of 5-day and 10-day regimens. The evidence reviewed in this article strongly supports reduction of the traditional 10-day course of antibacterial therapy to a 5-day course for uncomplicated acute maxillary sinusitis in adults. Further research related to the duration of antibacterial therapy for sinusitis is needed in children and in adult patients with frontal, ethmoidal and sphenoidal sinusitis.
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PMID:Short-course therapy for acute sinusitis: how long is enough? 1560 17

A prospective study of throat cultures and maxillary sinus aspirates from children with chronic sinusitis (n = 21), acute sinusitis (n = 28) or a clinical diagnosis of chronic adenoiditis (n = 41) was performed. Seventy-two bacterial pathogens were isolated from sinus aspirates from 52% of the study population. Haemophilus influenzae was most common pathogen, followed by Moraxella catarrhalis, Streptococcus pneumoniae, Staphylococcus aureus, and group A streptococci. Quantitative throat cultures had positive predictive values of 41%, 53% and 75% for H. influenzae, Strep. pneumoniae and M. catarrhalis, respectively, while negative predictive values were 93-98%, indicating that these three pathogens do not cause sinusitis when absent from the throat.
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PMID:Microbiology of sinusitis and the predictive value of throat culture for the aetiology of sinusitis. 1581 70

Sinusitis generally develops as a complication of viral or allergic inflammation of the upper respiratory tract. The bacterial pathogens in acute sinusitis are Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis, while anaerobic bacteria and Staphylococcus aureus are predominant in chronic sinusitis. Pseudomonas aeruginosa has emerged as a potential pathogen in immunocompromised patients and in those who have nasal tubes or catheters, or are intubated. Many of these organisms recovered from sinusitis became resistant to penicillins either through the production of beta-lactamase (H. influenzae, M. catarrhalis, S. aureus, Fusobacterium spp., and Prevotella spp) or through changes in the penicillin-binding protein (S. pneumoniae). The pathogenicity of beta-lactamase-producing bacteria is expressed directly through their ability to cause infections, and indirectly through the production of betalactamase. The indirect pathogenicity is conveyed not only by surviving penicillin therapy, but also by 'shielding' penicillin-susceptible pathogens from the drug. The direct and indirect virulent characteristics of these bacteria require the administration of appropriate antimicrobial therapy directed against all pathogens in mixed infections. The antimicrobials that are the most effective in management of acute sinusitis are amoxycillin-clavulanate (given in a high dose), the newer quinolones (gatifloxacin, moxifloxacin) and the second generation cephalosporins (cefuroxime, cefpodoxime, cefprozil or cefdinir). The antimicrobials that are the most effective in management of chronic sinusitis are amoxycillinclavulanate, clindamycin and the combination of metronidazole and a penicillin.
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PMID:Microbiology and antimicrobial management of sinusitis. 1594 76

Aspirates from 26 acutely and 17 chronically infected ethmoid sinuses were studied. Thirty-seven aerobes and 10 anaerobes were recovered from isolates from patients with acute sinusitis. Streptococcus pneumoniae and Haemophilus influenzae were predominant. Twenty-seven aerobes and 41 anaerobes were found in isolates from patients with chronic sinusitis. The predominant isolates were anaerobic gram-negative bacilli and Peptostreptococcus spp.
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PMID:Bacteriology of acute and chronic ethmoid sinusitis. 1600 Apr 83

Clinical practice guidelines for the management of acute sinusitis in children have been published by the American Academy of Pediatrics. Of note is that in this document, a brief discussion of chronic disease concluded that the pathogenesis and management are essentially unknown. Although there are insufficient data in the literature to develop evidence-based clinical guidelines, a careful review of the literature and clinical experience of experts who manage pediatric chronic sinusitis is presented in an effort to develop specific recommendations and to offer practical treatment options. Factors associated with chronic sinusitis should be addressed individually and include recurrent viral upper respiratory infections, allergic and nonallergic rhinitis, ciliary dyskinesia, cystic fibrosis, immunodeficiency, and anatomic abnormalities. Bacteriology includes the 3 pathogens associated with acute disease i.e., Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis but with chronic sinusitis also includes Staphylococcus aureus, anaerobic bacteria, and fungi. Medical interventions discussed include endoscopic sinus surgery, saline nasal irrigation, intranasal decongestant therapy, intranasal steroids, and oral antibiotics. Clinical ranking without regard to side effects and cost suggests that endoscopic sinus surgery and antral irrigation have the highest probability of substantial symptom improvement. Other issues discussed include identification and management of gastroesophageal reflux disease (GERD), allergy, and immune deficiency.
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PMID:Chronic sinusitis in children. 1601 92

The sinusitis is the term, which describes inflammation process of mucous membrane of these sinuses. Generally inflammation spreads from the nose to the paranasal sinus, so rhinosinusitis is the common name of disease. In classification of sinusitis two aspects are important--duration of signs and symptoms and changes in mucous membrane of sinus. In acute sinusitis symptoms withdraw after treatment, and mucous membrane comes back to the normal state. The most frequent bacteria's responsible for sinusitis are aerobes and among them: Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrrhalis, Streptococcus gr. A, Staphylococcus aureus, bacteria Gram (-) as well as anaerobic bacteria's. The inflammation changes of paranasal sinuses the most often enter on frontal ethmoid sinuses and then in frontal sinus, posterior ethmoid sinuses and the most seldom in sphenoid sinus. The diagnostics of sinusitis consisted of history data, otolaryngological examination, image diagnostics, bacteriological investigation, allergological diagnostics, sometimes alternatively, dentist as well as neurologist's consultations. The treatment of acute sinusitis is conservative. The aim of the treatment is control of inflammation, decrease of tissue oedema, facilitation of outflow of secretions of the nose and paranasal sinuses. We apply the antibiotics, glycocorticosteroids, decongestant drugs and mucolytic drugs. One should remember, that not treated or wrongly treated acute sinusitis can lead to chronic sinusitis or to numerous complications.
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PMID:[Acute sinusitis]. 1635 11


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