Pediatric Annals

CME Article 

Complications of Acute Bacterial Sinusitis in Children

Natalie E. Edmondson, MD; Sanjay R. Parikh, MD, FAAP, FACS

Abstract

A 15-year-old male presents to the emergency room with lethargy and frontal headache. He has had two days of intermittent low grade fever and poor appetite. Physical exam reveals that he is afebrile and slightly tachycardic. His neurologic and ophthalmologic examinations are normal. Examination of the nares reveals diffuse bilateral mucosal edema and muco-purulence under the middle turbinates. A computerized tomography (CT) scan of the sinuses and brain are obtained (see Figure 1 and Figure 2).

ABOUT THE AUTHORS

Natalie E. Edmondson, MD; and Sanjay R. Parikh, MD, FAAP, FACS, are with the Department of Otorhinolaryngology-Head and Neck Surgery, Children’s Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, N.Y.

Address correspondence to: Sanjay R. Parikh, MD, Department of Otorhinolaryngology, Head and Neck Surgery, Children’s Hospital at Montefiore, 3400 Bainbridge Ave, 3rd Floor, Bronx, NY 10467.

Dr. Edmondson and Dr. Parikh have disclosed no relevant financial relationships.

EDUCATIONAL OBJECTIVES

  1. Review the anatomy of the paranasal sinuses in children and the pathogenesis of sinus disease in this population.
  2. Provide a classification system for serious complications of sinusitis in children.
  3. Discuss the necessity of a team approach to management of serious complications of sinus disease in children.

Abstract

A 15-year-old male presents to the emergency room with lethargy and frontal headache. He has had two days of intermittent low grade fever and poor appetite. Physical exam reveals that he is afebrile and slightly tachycardic. His neurologic and ophthalmologic examinations are normal. Examination of the nares reveals diffuse bilateral mucosal edema and muco-purulence under the middle turbinates. A computerized tomography (CT) scan of the sinuses and brain are obtained (see Figure 1 and Figure 2).

ABOUT THE AUTHORS

Natalie E. Edmondson, MD; and Sanjay R. Parikh, MD, FAAP, FACS, are with the Department of Otorhinolaryngology-Head and Neck Surgery, Children’s Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, N.Y.

Address correspondence to: Sanjay R. Parikh, MD, Department of Otorhinolaryngology, Head and Neck Surgery, Children’s Hospital at Montefiore, 3400 Bainbridge Ave, 3rd Floor, Bronx, NY 10467.

Dr. Edmondson and Dr. Parikh have disclosed no relevant financial relationships.

EDUCATIONAL OBJECTIVES

  1. Review the anatomy of the paranasal sinuses in children and the pathogenesis of sinus disease in this population.
  2. Provide a classification system for serious complications of sinusitis in children.
  3. Discuss the necessity of a team approach to management of serious complications of sinus disease in children.

A 15-year-old male presents to the emergency room with lethargy and frontal headache. He has had two days of intermittent low grade fever and poor appetite. Physical exam reveals that he is afebrile and slightly tachycardic. His neurologic and ophthalmologic examinations are normal. Examination of the nares reveals diffuse bilateral mucosal edema and muco-purulence under the middle turbinates. A computerized tomography (CT) scan of the sinuses and brain are obtained (see Figure 1 and Figure 2).

ABOUT THE AUTHORS

Natalie E. Edmondson, MD; and Sanjay R. Parikh, MD, FAAP, FACS, are with the Department of Otorhinolaryngology-Head and Neck Surgery, Children’s Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, N.Y.

Address correspondence to: Sanjay R. Parikh, MD, Department of Otorhinolaryngology, Head and Neck Surgery, Children’s Hospital at Montefiore, 3400 Bainbridge Ave, 3rd Floor, Bronx, NY 10467.

Dr. Edmondson and Dr. Parikh have disclosed no relevant financial relationships.

EDUCATIONAL OBJECTIVES

  1. Review the anatomy of the paranasal sinuses in children and the pathogenesis of sinus disease in this population.
  2. Provide a classification system for serious complications of sinusitis in children.
  3. Discuss the necessity of a team approach to management of serious complications of sinus disease in children.

10.3928/00904481-20081001-08

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