Bacterial sinusitis in children

Bacterial sinusitis in children is one of the commonest infections during childhood. Sinusitis is infectious or non infectious inflammation of one or more sinuses. The inflammation can be caused by infectious (bacterial, viral, fungal) or non infectious (allergic) triggers.

Types of bacterial sinusitis in children

There are several classifications available for bacterial sinusitis in children. Factors used classify bacterial sinusitis are time period and the causative organisms. Following classification is based on the time period.

1. Acute bacterial sinusitis; Infection lasts less than four weeks and symptoms resolve completely with treatment (duration range 10-30 days).
2. Sub-acute bacterial sinusitis Infection lasting four to twelve weeks yet resolves completely with treatment.
3. Recurrent acute bacterial sinusitis Episodes last less than four weeks and are separated by intervals of at least ten days during which the patient is totally free of symptoms.
4. Chronic bacterial sinusitis Symptoms last more than twelve weeks with or without treatment.

Common bacteria causing bacterial sinusitis in children

1. Streptococcus pneumoniae 30%
2. Haemophilus influenzae 20%
3. Morexella catarrhalis 20%,
4. Streptococcus pyogenes (occasionally)
5. Staphylococcus aureus (occasionally)

Sign and symptoms of bacterial sinusitis in children

Nasal congestion and discharge, fever, cough, bad breath (halitosis), decreased sense of smell, periobital edema, headache and facial pain are the common symptoms of bacterial sinusitis in children.

Mild erythema in the nasal mucosa, Swelling of the nasal mucosa with nasal discharge, Sinus tenderness may be detected in adolescents and Anatomical anomalies (deviated nasal septum, polyp, large turbinate) are the common signs of bacterial sinusitis in children.

Predisposing factors for bacterial sinusitis in children

Pre-existing rhinitis (viral respiratory infections, allergic, intrinsic factors), Nasal foreign body, Upper respiratory tract infections (tonsillitis, adenoiditis), Nasal anatomical variations (septal deviations, abnormal turbinates), Gastro-oesophageal reflux,Exposure to cigarette smoking (air pollution), Immunocompromised host and Mucocilliary disorders (Kartagener syndrome) are the common local and general predisposing factors for bacterial sinusitis in children.

Aims of treatment of bacterial sinusitis in children

1. to resolve and limit the course of the acute infection
2. to prevent complications
3. to correct any precipitating factors.