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[Evaluation of predisposing factors and bacteriologic agents in pediatric rhinosinusitis].

OBJECTIVES
This study was conducted to investigate the predisposing factors and bacteriologic agents of acute rhinosinusitis in children.


PATIENTS AND METHODS
The study included 76 patients (47 girls, 29 boys; mean age 10.2 years; range 4 to 18 years) with acute rhinosinusitis. Following a detailed history, the patients were investigated by otolaryngologic examination including nasal endoscopy, allergy tests, Water's graphy, and aspiration cultures from the middle meatal region.


RESULTS
The leading complaints were nasal obstruction (92.1%), rhinorrhea (89.4%), and headache (51.3%). Allergy tests were positive in nine of 23 patients (30.3%) with a history of allergy. Concerning smoking, 39 patients (51.3%) had a secondary, two patients (2.6%) had a primary history. Sixteen patients (21.1%) had septal deviation, and 25 patients (32.9%) had benign adenoid tissue obstructing choanal spaces. Water's graphies showed pathology in 69 patients (93.2%). Cultures were positive in 51 patients (67.1%), with Streptococcus pneumoniae in 23 (41.1%), Haemophilus influenzae in 17 (30.4%), and beta-hemolytic streptococci in eight patients (14.2%). Treatment was comprised of ampicillin-sulbactam in 31 (40.8%), loracarbef in 20 (26.3%), and amoxicillin-clavulanate in 13 (17.1%) patients. After a year follow-up, recurrence was detected in 12 patients (15.8%). No significant effect of the size of adenoid tissue and allergy was found on the success of treatment (p>0.05).


CONCLUSION
Smoking, choanal obstruction by the adenoid tissue, anatomical variations, and allergy were the most frequent predisposing factors, while S. pneumoniae and H. influenzae were the commonest pathogens.