Evaluation of Children Diagnosed with Acute Bacterial Sinusitis: Single-center Experience
Journal Title: Ankara Üniversitesi Tıp Fakültesi Mecmuası - Year 2019, Vol 72, Issue 2
Abstract
Objectives: Acute bacterial sinusitis (ABS) is among frequent infections in children. Its diagnosis is clinical unless a suspicion of complication exists. This study aimed to evaluate pediatricians’ clinical approaches to ABS. Materials and Methods: This retrospective study analyzed diagnosis, treatment and complication data of patients diagnosed with ABS between June 2015 and June 2018 in our pediatric primary care unit. Results: The study group consisted of 536 patients [female/male 235/301 (43.8%/56.2%)]. The median age was 6.6 (7 months-17.9 years) years. Median duration of symptoms was 7 (1-46) days. Major complaints were cough (n=379, 70.7%), nasal discharge (n=234, 43.7%) and fever (n=168, 31.3%). Among 468 patients with available data, persistent (>10 days) upper respiratory tract infection (URTI) was present in 198 (42.3%) while 8 (1.7%) had severe URTI. Worsening URTI data could not be defined because of inadequate records. Duration of symptoms was <3 days in 26 (16.2%) patients. Physical examination revealed postnasal discharge (n=393, 73.3%), frontal pain (n=26, 4.9%) and sinus tenderness when pressure was applied (n=25, 4.7%). Water’s paranasal sinus radiograph was performed in 38 (7.1%) patients. Most preferred antibiotics were amoxicillin-clavulanate 167 (78.4%), clarithromycin 18 (8.5%) and cefdinir 13 (6.1%). Symptomatic treatment was rarely prescribed [nasal decongestant (n=38, 17.8%), systemic antihistamines (n=23, 10.8%]. The median treatment period was 10 (3-30) days. Five patients (0.9%) were hospitalized for complications [preseptal cellulitis (n=4), frontal bone osteomyelitis and subdural abscess secondary to facial cellulitis (n=1)]. Patients with preseptal cellulitis were treated with parenteral ampicillin-sulbactam and the patient with osteomyelitis and abscess received ceftriaxone, vancomycin and metronidazole treatment following abscess drainage. Conclusion: Our results indicate that the diagnosis was substantially based on clinical evaluation even though complete compliance to clinical definitions recommended by current guidelines was lacking, and antibiotic treatment plans were often correct. Moreover, although rare, performance of further investigations and/or prescription of symptomatic treatment were observed. It was aimed to emphasize that clinicians should be encouraged for complete patient records and compliance to current guidelines.
Authors and Affiliations
Nisa Eda Çullas İlarslan, Fatih Günay, Emine Çiğdem Özer, Dilara Beşli Çelik, Esra Çakmak Taşkın, Halil Özdemir, Erdal İnce, Ergin Çiftçi
Keywords
Related Articles
- EP ID EP671737
- DOI 10.4274/atfm.galenos.2019.84803
- Views 255
- Downloads 0
Stereotactic Radiofrequency Deep Brain Lesioning in Treatment of Dystonia
Objectives: Movement disorders are neurologic diseases that affect speed, quality and feasibility of muscle contractions. Aim of this study is, to assess the surgical outcomes of radiofrequency lesioning through deep bra...
Evaluation of Time and Color Perception in Children and Adults
Objectives: The study aimed to compare the time and color perception among adults and children to reveal the age-dependent change of the time perception. Materials and Methods: The children (n=30; age: 7-12, 50% female)...
Are Plasma Neutrophil Gelatinase Associated Lipocalin Levels Diagnostic in Uncomplicated Urinary Tract Infections?
Objectives: Acute uncomplicated lower urinary tract infections are among the most common causes for emergency department visits and empirical antibiotic prescriptions. The purpose of this study was to determine whether t...
Effects of Hypothyroidism on Central and Peripheral Atherosclerosis in the Old Aged
Objectives: Aging is associated with an increased incidence of thyroid function abnormalities. Thyroid hormones have been shown to affect vascular hemodynamics and arterial stiffness. Arterial stiffness appears to be an...
Correlation Between the Kidney Volume and Body Parametres in Normal Adults
Objectives: Evaluation of kidney size and volume is very important in the diagnosis, treatment and follow-up of kidney diseases. Ultrasonography is the preferred imaging modality which provides a safe, reliable and affor...