Microbiology and choice of antimicrobial therapy for acute sinusitis complicated by subperiosteal abscess in children

Brook, Itzhak

doi:10.1016/j.ijporl.2016.02.022

Cited by 25 publications

(19 citation statements)

References 33 publications

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“…In a recent review, Brook 13 reported on the consistent isolation of S. milleri and E. corrodens from SPAs, which was also noted in our series. Interestingly, the S. milleri – S. anginosus group, in particular, are known to cause in abscess formation in the head and neck and have also shown to be involved in polymicrobial infections, 13 resulting in significant morbidity 24 . It is therefore important that the antibiotic regime administered is broad spectrum and able to cover the majority of these organisms.…”

Section: Discussionsupporting

confidence: 87%

“…Wide variation in causative organisms has been described in the literature with the most common organisms from SPAs secondary to sinusitis being aerobic and anaerobic organisms of the oropharyngeal flora 13,14 …”

Section: Discussionmentioning

confidence: 99%

“…The advent of the Pneumococcal and H. influenzae type b (HiB) vaccinations have reduced the incidence of streptococci 15,16 and HiB; however, this has correlated with an increased incidence of S. aureus as well as methicillin‐resistant S. aureus (MRSA), 15‐17 not only in SPAs but also in rhinosinusitis 17 . It is also thought that this has been associated with an increase in cases of S. milleri – S. anginosus group and S. pyogenes 13,16,18,19 . Anaerobic organisms or oropharyngeal flora are also commonly detected.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, this class of antibiotics crosses the blood‐brain barrier, hence would play a role against intracranial complications. They are still active against streptococci, hence their use has continued; however, they are not effective against anaerobic organisms of the oropharyngeal flora; hence, the addition of metronidazole or clindamycin has been recommended 13 . In some cases the addition of flucloxacillin has been advised 26 because there is some controversy as to whether ceftriaxone alone has sufficient anti‐staphylococcal cover 7 …”

Section: Discussionmentioning

confidence: 99%

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The management of periorbital cellulitis secondary to sinonasal infection: a multicenter prospective study in the United Kingdom

Mahalingam

Hone

Lloyd

et al. 2020

Int Forum Allergy Rhinol

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Background: Periorbital cellulitis is a potential sightthreatening complication of sinusitis. The majority of patients improve with medical management. Previous studies have suggested significant variations in practice and lack of evidence regarding the optimal management of this condition. Methods:A prospective study was conducted over a 12month period at 8 centers in the United Kingdom assessing the management of patients requiring inpatient treatment for periorbital cellulitis secondary to sinonasal infections. Results:A total of 143 patients were recruited, of whom 40 were excluded. Of the remaining 103 patients, 5 (4.9%) were diagnosed with neurosurgical complications. This resulted in 98 patients admi ed with periorbital cellulitis secondary to an upper respiratory tract infection/sinusitis. A total of 72 were children, of whom 12 (16.7%) required surgical intervention; and of 26 adults, 5 (19.2%) required surgery: the most common antimicrobial regimes administered were intravenous ce riaxone (with or without metronidazole), and co-amoxiclav. The use of both ce riaxone and metronidazole from admission was associated with the shortest duration of inpatient stay (3.8 days) in com-parison to ce riaxone alone (5.8 days) or co-amoxiclav (4.5 days) and a reduction in number of patients requiring surgical intervention. There was also an association between the early use of intranasal decongestants and steroids and reduction in requirement for surgical intervention. Conclusion:For a condition where swab and blood cultures are o en negative, this study supports the use of ce riaxone in combination with metronidazole. The administration of intranasal decongestants and corticosteroids correlated with a smaller percentage of those progressing to surgery in those with and without periorbital abscesses. C 2020 ARS-AAOA, LLC.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The management of periorbital cellulitis secondary to sinonasal infection: a multicenter prospective study in the United Kingdom

Mahalingam

Hone

Lloyd

et al. 2020

Int Forum Allergy Rhinol

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“…Streptococci and Hemophiluswere next commonest respectively. Flora noted in other studies include Streptococcus viridans, coagulase negative Staphylococcusandpolymicrobial isolates [6] .…”

Section: Discussionmentioning

confidence: 97%

Orbital complications of acute rhinosinusitis: a study on clinical profile, surgical management and outcome

Rosa

Warnasuriya

Kirihene

2018

Ceylon J Otolaryngology

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Objectives 1. Evaluate the clinical signs and their correlation to Computed Tomography(CT) findings 2. Assess the correlation between CT and intra-operative findings. 3. To identify implicated microorganisms. 4. Evaluate the current practice in surgical management. Methodology A descriptive retrospective study conducted at Lady Ridgeway Hospital (LRH) on 19 patients who underwent endoscopic sinus surgery, drainage of pus and orbital decompression for radiologically suspected orbital complications of acute rhinosinusitis from 01/01/2015 to 31/12/2018. Results Clinical features were fever (73.7%), peri-orbital swelling (100%), chemosis(68.4%), proptosis(57.9%) and ophthalmoplegia(42.1%). Chemosis and ophthalmoplegia were found in 62% and 37% of the patients with intra-orbital abscesses, with only chemosis showing a statistically significant association. CT was suggestive of subperiosteal abscess or inflammation in all. Intra-operatively abscesses were found in 16 (84.2%). Of these 6 had both subperiosteal and intra-orbital abscesses. Eight had subperiosteal abscesses. Two had only intra-orbital abscesses. The CT scan failed to predict the presence of abscess within the orbital fat in 3 out of 8. The positive predictive value was 89.4% for CT to detect orbital abscesses. An Intra-operative bony defect was noted in 15.8%. The mean surgery duration was 2.04 hours. Cultures revealed MRSA(21.1%), MSSA(15.8%), Pseudomonas(10.5%), mixed growth(10.6%) and Streptococcus viridans(5.3%). Conclusion The commonest presentations were peri-orbital swelling, fever, chemosis. MRSA and pseudomonas being the commonest organism, the appropriate empirical therapy needs further discussion. Endoscopic surgery is safe, reliable and cosmetic. As patients with intra-orbital abscesses may not be detected clinically or radiologically, we recommend routine incision of the orbital periosteum for suspected orbital complications of acute rhinosinusitis when undergoing endoscopic surgery.

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Acute and Chronic Rhinosinusitis

Öçal,

Cingi,

Friedman

2023

Airway Diseases

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Microbiology and choice of antimicrobial therapy for acute sinusitis complicated by subperiosteal abscess in children

Cited by 25 publications

References 33 publications

The management of periorbital cellulitis secondary to sinonasal infection: a multicenter prospective study in the United Kingdom

The management of periorbital cellulitis secondary to sinonasal infection: a multicenter prospective study in the United Kingdom

Orbital complications of acute rhinosinusitis: a study on clinical profile, surgical management and outcome

Acute and Chronic Rhinosinusitis

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