Sinusitis resident survival guide (pediatrics): Difference between revisions

Jump to navigation Jump to search
No edit summary
 
(9 intermediate revisions by the same user not shown)
Line 6: Line 6:
|}
|}


{{CMG}} {{AE}}
{{CMG}} {{AE}} {{ Samah Obaiah}}


{{SK}}
{{SK}}
Line 30: Line 30:


==Overview==
==Overview==
Since inflammation of the sinuses rarely occurs without concurrent inflammation of the nasal mucosa, the term "rhinosinusitis" is preferred to "sinusitis" which is defined as inflammation of the nasal cavity and paranasal sinuses. Infections in the respiratory tract — most commonly colds — can inflame and thicken in sinus membranes and block mucus drainage. These infections can be viral, bacterial, or fungal.
Since inflammation of the sinuses rarely occurs without concurrent inflammation of the nasal mucosa, the term "rhinosinusitis" is preferred to "sinusitis" which is defined as inflammation of the nasal cavity and paranasal sinuses. Infections in the respiratory tract — most commonly colds — can inflame and thicken in sinus membranes and block mucus drainage. These infections can be viral, bacterial, or fungal. Acute rhinosinusitis (ARS) is defined as symptomatic inflammation of the nasal cavity and paranasal sinuses lasting less than four weeks. Acute viral rhinosinusitis (AVRS) focuses on symptomatic management as it typically resolves within 7 to 10 days. Acute bacterial sinusitis is a complication of viral upper respiratory infection (URI) or allergic inflammation.  Acute sinusitis has been observed that between 6% and 7% of children seeking care for respiratory symptoms have an illness. The sinuses in the forehead don't start developing until kids are 9 or 12 years old and aren't formed enough to get infected until the early teen years for that, cold-related headaches in young kids usually aren't sinus infections. The most common bacteria that cause acute sinusitis include; Streptococcus pneumonia, Haemophilus influenza, Moraxella catarrhalis<ref name="pmid1527337">{{cite journal| author=Gwaltney JM, Scheld WM, Sande MA, Sydnor A| title=The microbial etiology and antimicrobial therapy of adults with acute community-acquired sinusitis: a fifteen-year experience at the University of Virginia and review of other selected studies. | journal=J Allergy Clin Immunol | year= 1992 | volume= 90 | issue= 3 Pt 2 | pages= 457-61; discussion 462 | pmid=1527337 | doi=10.1016/0091-6749(92)90169-3 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1527337  }} </ref>.


==Causes=
==Causes==
===Common Causes===
===Common Causes===
* [[A viral infection]]
* [[A viral infection]]
Line 44: Line 44:
* [[Aspirin sensitivity]]
* [[Aspirin sensitivity]]
* [[ Prolonged intubation lead to nosocomial bacterial sinusitis ]]
* [[ Prolonged intubation lead to nosocomial bacterial sinusitis ]]
*[[Nose injury]]
*[[Foreign object in the nose]]
*[[Birth defect]] with an abnormality of the roof of the mouth ([[cleft palate]])
* Problem with [[stomach acids]] ([[gastroesophageal reflux]] disease, or GERD)
*[[Cystic fibrosis]] and [[immunodeficiency syndromes]]
Immune problems or antibody deficiencies are risks for chronic sinus conditions


==Complete Diagnostic Approach==
==Complete Diagnostic Approach==
Shown below is an algorithm summarizing the diagnosis of <nowiki>[[disease name]]</nowiki> according the the [...] guidelines.
Shown below is an algorithm summarizing the diagnosis of <nowiki>[[disease name]]</nowiki> according the the [...] guidelines.
{{familytree/start |summary=PE diagnosis Algorithm.}}
{{familytree/start |summary=PE diagnosis Algorithm.}}
{{familytree | | | | A01 | | | A01=Purulent anterior nasal discharge  
{{familytree | | | | A01 | | | A01=Symptoms of acute rhinosinusitis:-
Purulent or discolored posterior nasal discharge  
Purulent anterior nasal discharge  
Nasal congestion or obstruction  
Purulent or discolored posterior nasal discharge  
Facial congestion or fullness  
Nasal congestion or obstruction  
Hyposmia or anosmia  
Facial congestion or fullness
Fever  
Hyposmia or anosmia
Headache  
Fever  
Ear pain, pressure, or fullness  
Headache  
Halitosis  
Ear pain, pressure, or fullness  
Dental pain  
Halitosis  
Fatigue  
Dental pain  
  }}
Fatigue  }}
{{familytree | | | | |!| | | | }}
{{familytree | | | | |!| | | | }}
{{familytree | | | | B01 | | | B01= }}
{{familytree | | | | B01 | | | B01=Sinus X-rays.
An X-ray exam of the sinuses may help with the diagnosis.
CT scan of the sinuses.
A CT scan shows detailed images of any part of the body.
They are more detailed than X-rays.
Cultures from the sinuses.
A swab of discharge from the nose may be taken. The sample is checked for bacteria or other germs. }}
{{familytree | | |,|-|^|-|.| | }}
{{familytree | | |,|-|^|-|.| | }}
{{familytree | | C01 | | C02 | C01= | C02= }}
{{familytree | | C01 | | C02 | C01= | C02= }}

Latest revision as of 14:31, 14 April 2021



Resident
Survival
Guide

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Samah Obaiah, MD[2]

Synonyms and keywords:

Sinusitis resident survival guide (pediatrics) Microchapters
Overview
Causes
FIRE
Diagnosis
Treatment
Do's
Don'ts

Overview

Since inflammation of the sinuses rarely occurs without concurrent inflammation of the nasal mucosa, the term "rhinosinusitis" is preferred to "sinusitis" which is defined as inflammation of the nasal cavity and paranasal sinuses. Infections in the respiratory tract — most commonly colds — can inflame and thicken in sinus membranes and block mucus drainage. These infections can be viral, bacterial, or fungal. Acute rhinosinusitis (ARS) is defined as symptomatic inflammation of the nasal cavity and paranasal sinuses lasting less than four weeks. Acute viral rhinosinusitis (AVRS) focuses on symptomatic management as it typically resolves within 7 to 10 days. Acute bacterial sinusitis is a complication of viral upper respiratory infection (URI) or allergic inflammation. Acute sinusitis has been observed that between 6% and 7% of children seeking care for respiratory symptoms have an illness. The sinuses in the forehead don't start developing until kids are 9 or 12 years old and aren't formed enough to get infected until the early teen years for that, cold-related headaches in young kids usually aren't sinus infections. The most common bacteria that cause acute sinusitis include; Streptococcus pneumonia, Haemophilus influenza, Moraxella catarrhalis[1].

Causes

Common Causes

Immune problems or antibody deficiencies are risks for chronic sinus conditions

Complete Diagnostic Approach

Shown below is an algorithm summarizing the diagnosis of [[disease name]] according the the [...] guidelines.

 
 
 
Symptoms of acute rhinosinusitis:-
Purulent anterior nasal discharge 
Purulent or discolored posterior nasal discharge 
Nasal congestion or obstruction 
Facial congestion or fullness  
Hyposmia or anosmia  
Fever 
Headache 
Ear pain, pressure, or fullness 
Halitosis 
Dental pain 
Fatigue
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Sinus X-rays.
An X-ray exam of the sinuses may help with the diagnosis.

CT scan of the sinuses.

A CT scan shows detailed images of any part of the body.
They are more detailed than X-rays.

Cultures from the sinuses.

A swab of discharge from the nose may be taken. The sample is checked for bacteria or other germs.
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Treatment

Shown below is an algorithm summarizing the treatment of [[disease name]] according the the [...] guidelines.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Do's

  • The content in this section is in bullet points.

Don'ts

  • The content in this section is in bullet points.

References

  1. Gwaltney JM, Scheld WM, Sande MA, Sydnor A (1992). "The microbial etiology and antimicrobial therapy of adults with acute community-acquired sinusitis: a fifteen-year experience at the University of Virginia and review of other selected studies". J Allergy Clin Immunol. 90 (3 Pt 2): 457–61, discussion 462. doi:10.1016/0091-6749(92)90169-3. PMID 1527337.