Complications of Sinusitis in Children

Abstract

Eight patients (6-15 yr old) who had periorbital cellulitis and other complications of sinusitis were studied. Both ethmoid and maxillary sinusitis were present in 4 patients, frontal sinusitis in 2, and ethmoid sinusitis and pansinusitis in 1 patient each. Subdural empyema occurred in 4 patients, in 1 case accompanied by cerebritis and brain abscess and in another by meningitis. Periorbital abscess was present in 2 children who had ethmoiditis. Alveolar abscess in the upper incisors was present in 2 children whose infection had spread to the maxillary and ethmoid sinuses. Anaerobic bacteria were isolated from the infected sinuses in all the patients. These were 7 isolates of Bacteroides sp., 4 Fusobacterium sp., 3 microaerophilic streptococci, 3 Gram-positive anaerobic cocci, and 2 Veillonella sp. There was only 7 aerobic isolate recovered, a group F .beta.-hemolytic Streptococcus. Surgical drainage and appropriate antimicrobial therapy resulted in complete eradication of the infection in all patients. The role of anaerobic bacteria in sinus infection and its subsequent complication is discussed. Given the possible serious complications of this disease, the early recognition of sinusitis in children and the institution of appropriate antimicrobial and surgical therapy are of great clinical importance.