Incidence and Significance of Sinusitis in Pneumonia

Abstract

In a study on the incidence of sinusitis one is impressed not only by the great prevalence of such infection in this locality, but also by the great frequency with which it is found in close association with certain illnesses such as otitis media, mastoiditis, the exanthematous diseases and pneumonia. Statistics on such associations are lacking and, in their absence, it is perhaps not justifiable to attach any great significance to their relationship, but in the instances of otitis media and pneumonia the frequent, almost constant presence of sinusitis at least strongly suggests an etiologic relationship. Two years ago I1 published the results of a study on the association of otitis media and sinusitis, emphasized the probable etiologic relationship between the two conditions, and advocated energetic treatment of such infections of the sinus, as both a prophylactic and a therapeutic measure in the control of infections of the middle ear.In this contribution I wish to present my observations on the association of sinusitis and pneumonia. In the past few years, in the exami¬ nation of several hundred infants and children with pneumonia, I have been impressed by the constant presence of acute sinusitis, but only recently have I attempted to record these observations and to draw any conclusion from them. These observations cover a study of the condi¬ tion of the sinuses and ears in 130 patients with lobar and broncho¬ pneumonia observed in the Children's Hospital of Philadelphia, the University of Pennsylvania Hospital and St. Christopher's Hospital for Children during the past two years. They represent a consecutive unselected group varying in age from 3 weeks to 90 years. Acute sinusitis was found in 100 per cent of these patients with pneumonia. METHODThe procedure of examinations of the nose, throat and ears was as follows: (1) gross inspection of the nose, the degree of congestion of the nasal mucous membrane, the engorgement of the turbinâtes, the From the