Abstract
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.
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Aebert, H., Hünefeld, G. & Regel, G. Paranasal sinusitis and sepsis in ICU patients with nasotracheal intubation. Intensive Care Med 15, 27–30 (1988). https://doi.org/10.1007/BF00255632
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DOI: https://doi.org/10.1007/BF00255632