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Clin Infect Dis. 2019 Jan 14. doi: 10.1093/cid/ciz023. [Epub ahead of print]

Clinical and Virological Characteristics of Acute Sinusitis in Children.

Author information

1
Department of Pediatrics University of Wisconsin School of Medicine and Public Health Madison, WI USA.
2
Department of Biostatistics and Medical Informatics University of Wisconsin School of Medicine and Public Health Madison, WI USA.

Abstract

Background:

Acute bacterial sinusitis is a frequent complication of viral upper respiratory infection (URI). We describe clinical and virologic features of URIs that remain uncomplicated and those that precede an episode of sinusitis. We hypothesize that certain viruses are more likely to lead to acute sinusitis and compare viruses identified at time of diagnosis of sinusitis with those identified early in the URI.

Methods:

Children ages 48-96 months were followed longitudinally for one year. Nasal samples were obtained at surveillance visits, on day 3-4 of URI and on day 10, when sinusitis was diagnosed. Molecular diagnostic testing was performed on nasal washes for common respiratory viruses and pathogenic bacteria. A standardized score was used to quantify symptom severity.

Results:

519 URIs were evaluated and 37 illnesses in 31 patients met criteria for sinusitis. RSV was detected more frequently in URI visits that led to sinusitis compared to uncomplicated URI (10.8% vs. 3.4%, p=.05). New viruses were detected in 29% of sinusitis episodes and their pattern was different than those observed at surveillance. The median number of URIs per subject per year was 1 (range 0-9) in uncomplicated URI subjects and 3 (range 1-9) in sinusitis subjects (p<0.001).

Conclusions:

Children who developed sinusitis experienced more frequent URIs compared to children whose URIs remained uncomplicated. When nasal samples were obtained on the day of diagnosis of acute sinusitis, nearly 30% of children had identification of a new virus suggesting that some children deemed to have sinusitis are experiencing sequential viral infections.

PMID:
30649261
DOI:
10.1093/cid/ciz023

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