Skip to main content
Log in

Paranasal sinusitis and sepsis in ICU patients with nasotracheal intubation

  • Original Articles
  • Published:
Intensive Care Medicine Aims and scope Submit manuscript


During a 1-year period 4 out of 171 nasotracheally intubated patients (2.3%) developed sepsis due to purulent sinusitis. 98 (57%) of the patients received mechanical ventilation for more than 10 days. In all cases of sinusitis the diagnosis could be confirmed by conventional X-ray examination. Sepsis resolved 1 to 3 days after initiation of a therapy protocol consisting of tracheostomy, surgical drainage and lavage. Pseudomonas aeruginosa was involved as pathogenic organism in 3 of 4 patients. We conclude that purulent sinusitis represents a serious and often occult problem in already critically ill patients with multiple potential sources of sepsis. Most important for diagnosis is a high level of suspicion particularly in patients with risk factors for infection. Prompt and successful treatment can be achieved by an aggressive surgical approach.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others


  1. Caplan ES, Hoyt NJ (1982) Nosocomial sinusitis. JAMA 247:639

    Google Scholar 

  2. Deutschman CS, Wilton PB, Sinow J, Thienprasit P, Konstantinides FN, Cerra FB (1985) Paranasal sinusitis: a common complication of nasotracheal intubation in neurosurgical patients. Neurosurgery 17:296

    Google Scholar 

  3. Dunham CM, LaMonica C (1984) Prolonged tracheal intubation in the trauma patient. J Trauma 24:120

    Google Scholar 

  4. Evans FO Jr, Sydnor JB, Moore WEC, Moore GR, Manwaring JL, Brill AH, Jackson RT, Hanna S, Skaar JS, Holdeman LV, Fitz-Hugh GS, Sande MA, Gwaltney JM Jr (1975) Sinusitis of the maxillary antrum. N Engl J Med 293:735

    Google Scholar 

  5. Fried MP, Kelly JH, Strome M (1984) Pseudomonas rhinosinusitis. Laryngoscope 94:192

    Google Scholar 

  6. Gwaltney JM (1983) Acute sinusitis in adults. Am J Otolaryngol 4:422

    Google Scholar 

  7. Hamory BH, Sande MA, Sydnor A Jr, Seale DL, Gwaltney JM Jr (1979) Etiology and antimicrobial therapy of acute maxillary sinusitis. J Infect Dis 139:197

    Google Scholar 

  8. Hünefeld G, Friedel N, Pichlmayr R (1986) Versuch einer Klassifizierung bei Patienten mit Peritonitis — Auswertung bei 53 Patienten. Langenbecks Arch chir 368:113

    Google Scholar 

  9. Hünefeld G, Weissbrodt H, Aebert H, Bunzendahl H (1986) Kalkulierte initiale Chemotherapie bei beatmeten postoperativen Patienten mit Peritonitis, Sepsis bzw. Pneumonie. Infection 14 [Suppl. 2]:164

    Google Scholar 

  10. Knodel AR, Beekman JF (1982) Unexplained fevers in patients with nasotracheal intubation. JAMA 248:868

    Google Scholar 

  11. Kronberg FG, Goodwin WJ Jr (1985) Sinusitis in intensive care unit patients. Laryngoscope 95:936

    Google Scholar 

  12. Lew D, Southwick FS, Montgomery WW, Weber AL, Baker AS (1983) Sphenoid sinusitis — a review of 30 cases. N Engl J Med 309:1149

    Google Scholar 

  13. O'Reilly MJ, Reddick EJ, Black W, Carter PL, Erhardt J, Fill W, Maughn D, Sado A, Klatt GR (1984) Sepsis from sinusitis in nasotracheally intubated patients. Am J Surg 147:601

    Google Scholar 

  14. Pippin LK, Short DH, Bowes JB (1983) Long-term tracheal intubation practice in the United Kingdom. Anaesthesia 38:791

    Google Scholar 

Download references

Author information

Authors and Affiliations


Rights and permissions

Reprints and permissions

About this article

Cite this article

Aebert, H., Hünefeld, G. & Regel, G. Paranasal sinusitis and sepsis in ICU patients with nasotracheal intubation. Intensive Care Med 15, 27–30 (1988).

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI:

Key words