Complications of Acute Bacterial Sinusitis in Children

Chapter

Abstract

Complications of acute bacterial sinusitis are rare, occurring in <1% of cases. These complications relate directly to the proximity of the paranasal sinuses to the orbit and the brain. Complications may be categorized as orbital, intracranial, and those involving the bone of the frontal sinus. Orbital manifestations may be divided into preseptal or post-septal infections. Outcomes depend on prompt recognition of orbital and intracranial involvement, early intervention with antimicrobials and, when needed, surgical drainage. This chapter reviews the epidemiology, pathophysiology, clinical presentation, microbiology, and therapy of complications of acute bacterial sinusitis in children.

Keywords

Sinusitis Complications Children Orbital abscess Orbital cellulitis Periorbital cellulitis Subdural empyema Epidural empyema Brain abscess Cavernous sinus thrombosis 

Notes

Acknowledgement

This work was supported by a grant from the National Institutes of Health/National Institute of Allergy and Infectious Diseases (R01 AI097172).

References

  1. 1.
    Berg O, Carenfelt C, Rystedt G, Anggard A.Occurrence of asymptomatic sinusitis in common cold and other acute ENT-infections. Rhinology. 1986;24(3):223–5.PubMedGoogle Scholar
  2. 2.
    Wald ER, Guerra N, Byers C. Upper respiratory tract infections in young children: duration of and frequency of complications. Pediatrics. 1991;87(2):129–33.PubMedGoogle Scholar
  3. 3.
    DeMuri GP, Gern JE, Moyer SC, Lindstrom MJ, Lynch SV, Wald ER. Clinical features, virus identification, and sinusitis as a complication of upper respiratory tract illness in children ages 4-7 years. J Pediatr. 2016;171:133–9. e1CrossRefGoogle Scholar
  4. 4.
    Ray NF, Baraniuk JN, Thamer M, Rinehart CS, Gergen PJ, Kaliner M, et al. Healthcare expenditures for sinusitis in 1996: contributions of asthma, rhinitis, and other airway disorders. J Allergy Clin Immunol. 1999;103(3 Pt 1):408–14.CrossRefGoogle Scholar
  5. 5.
    Hansen FS, Hoffmans R, Georgalas C, Fokkens WJ. Complications of acute rhinosinusitis in The Netherlands. Fam Pract. 2012;29(2):147–53.CrossRefGoogle Scholar
  6. 6.
    Sedaghat AR, Wilke CO, Cunningham MJ, Ishman SL. Socioeconomic disparities in the presentation of acute bacterial sinusitis complications in children. Laryngoscope. 2014;124(7):1700–6.CrossRefGoogle Scholar
  7. 7.
    Patel NA, Garber D, Hu S, Kamat A. Systematic review and case report: intracranial complications of pediatric sinusitis. Int J Pediatr Otorhinolaryngol. 2016;86:200–12.CrossRefGoogle Scholar
  8. 8.
    Sobol SE, Marchand J, Tewfik TL, Manoukian JJ, Schloss MD. Orbital complications of sinusitis in children. J Otolaryngol. 2002;31(3):131–6.CrossRefGoogle Scholar
  9. 9.
    Shapiro ED, Wald ER, Doyle W, Rohn D. Bacteriology of the maxillary sinus of rhesus monkeys. Ann Otol Rhinol Laryngol. 1982;91(2 Pt 1):150–1.CrossRefGoogle Scholar
  10. 10.
    Eviatar E, Sandbank J, Kleid S, Gavriel H. The role of osteitis of the lamina papyracea in the formation of subperiosteal orbital abscess in young children. Int J Pediatr Otorhinolaryngol. 2014;78(12):2267–70.CrossRefGoogle Scholar
  11. 11.
    Botting AM, McIntosh D, Mahadevan M. Paediatric pre- and post-septal peri-orbital infections are different diseases. A retrospective review of 262 cases. Int J Pediatr Otorhinolaryngol. 2008;72(3):377–83.CrossRefGoogle Scholar
  12. 12.
    Chandler JR, Langenbrunner DJ, Stevens ER. The pathogenesis of orbital complications in acute sinusitis. Laryngoscope. 1970;80(9):1414–28.CrossRefGoogle Scholar
  13. 13.
    Sharma A, Liu ES, Le TD, Adatia FA, Buncic JR, Blaser S, et al. Pediatric orbital cellulitis in the Haemophilus influenzae vaccine era. J AAPOS. 2015;19(3):206–10.CrossRefGoogle Scholar
  14. 14.
    Germiller JA, Monin DL, Sparano AM, Tom LW. Intracranial complications of sinusitis in children and adolescents and their outcomes. Arch Otolaryngol Head Neck Surg. 2006;132(9):969–76.CrossRefGoogle Scholar
  15. 15.
    Garin A, Thierry B, Leboulanger N, Blauwblomme T, Grevent D, Blanot S, et al. Pediatric sinogenic epidural and subdural empyema: the role of endoscopic sinus surgery. Int J Pediatr Otorhinolaryngol. 2015;79(10):1752–60.CrossRefGoogle Scholar
  16. 16.
    Kristo A, Uhari M. Timing of rhinosinusitis complications in children. Pediatr Infect Dis J. 2009;28(9):769–71.CrossRefGoogle Scholar
  17. 17.
    Bair-Merritt MH, Shah SS, Zaoutis TE, Bell LM, Feudtner C. Suppurative intracranial complications of sinusitis in previously healthy children. Pediatr Infect Dis J. 2005;24(4):384–6.CrossRefGoogle Scholar
  18. 18.
    Carr TF. Complications of sinusitis. Am J Rhinol Allergy. 2016;30(4):241–5.CrossRefGoogle Scholar
  19. 19.
    Smith DM, Vossough A, Vorona GA, Beslow LA, Ichord RN, Licht DJ. Pediatric cavernous sinus thrombosis: a case series and review of the literature. Neurology. 2015;85(9):763–9.CrossRefGoogle Scholar
  20. 20.
    Press CA, Lindsay A, Stence NV, Fenton LZ, Bernard TJ, Mirsky DM. Cavernous sinus thrombosis in children: imaging characteristics and clinical outcomes. Stroke. 2015;46(9):2657–60.CrossRefGoogle Scholar
  21. 21.
    Sweis R, Biller J. Cavernous sinus thrombosis in children. Pediatr Neurol Briefs. 2016;30(1):4.CrossRefGoogle Scholar
  22. 22.
    Bambakidis NC, Cohen AR. Intracranial complications of frontal sinusitis in children: pott’s puffy tumor revisited. Pediatr Neurosurg. 2001;35(2):82–9.CrossRefGoogle Scholar
  23. 23.
    Wald ER. Periorbital and orbital infections. Infect Dis Clin North Am. 2007;21(2):393–408. viCrossRefGoogle Scholar
  24. 24.
    Wald ER, Demuri GP. Antibiotic recommendations for acute otitis media and acute bacterial sinusitis in 2013 - the conundrum. Pediatr Infect Dis J. 2013;32:641.CrossRefGoogle Scholar
  25. 25.
    Brook I. Bacteriology of chronic sinusitis and acute exacerbation of chronic sinusitis. Arch Otolaryngol Head Neck Surg. 2006;132(10):1099–101.CrossRefGoogle Scholar
  26. 26.
    Schlosser RJ, London SD, Gwaltney JM Jr, Gross CW. Microbiology of chronic frontal sinusitis. Laryngoscope. 2001;111(8):1330–2.CrossRefGoogle Scholar
  27. 27.
    Liao S, Durand ML, Cunningham MJ. Sinogenic orbital and subperiosteal abscesses: microbiology and methicillin-resistant Staphylococcus aureus incidence. Otolaryngol Head Neck Surg. 2010;143(3):392–6.CrossRefGoogle Scholar
  28. 28.
    Lindstrand A, Bennet R, Galanis I, Blennow M, Ask LS, Dennison SH, et al. Sinusitis and pneumonia hospitalization after introduction of pneumococcal conjugate vaccine. Pediatrics. 2014;134(6):e1528–36.CrossRefGoogle Scholar
  29. 29.
    Brook I. Microbiology and choice of antimicrobial therapy for acute sinusitis complicated by subperiosteal abscess in children. Int J Pediatr Otorhinolaryngol. 2016;84:21–6.CrossRefGoogle Scholar
  30. 30.
    Dankbaar JW, van Bemmel AJ, Pameijer FA. Imaging findings of the orbital and intracranial complications of acute bacterial rhinosinusitis. Insights Imaging. 2015;6(5):509–18.CrossRefGoogle Scholar
  31. 31.
    Younis RT, Anand VK, Davidson B. The role of computed tomography and magnetic resonance imaging in patients with sinusitis with complications. Laryngoscope. 2002;112(2):224–9.CrossRefGoogle Scholar
  32. 32.
    Wald ER, Applegate CB, Darrow D, Glode M, Marcy M, Nelson C, et al. Clinical practice guideline for diagnosis and management of acute bacterial sinusitis in chilren 1-18. Pediatrics. 2013;132:e262.CrossRefGoogle Scholar
  33. 33.
    Eviatar E, Gavriel H, Pitaro K, Vaiman M, Goldman M, Kessler A. Conservative treatment in rhinosinusitis orbital complications in children aged 2 years and younger. Rhinology. 2008;46(4):334–7.PubMedGoogle Scholar
  34. 34.
    Oxford LE, McClay J. Medical and surgical management of subperiosteal orbital abscess secondary to acute sinusitis in children. Int J Pediatr Otorhinolaryngol. 2006;70(11):1853–61.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of PediatricsUniversity of Wisconsin School of Medicine and Public HealthMadisonUSA

Personalised recommendations