Acute sinusitis in children

Acute sinusitis (synonyms: acute ethmoiditis, acute maxillary sinusitis, acute frontal sinusitis, acute sphenoiditis).

Acute sinusitis is an acute inflammation of the mucous membrane of the paranasal sinuses.

ICD-10 code

• J01 Acute sinusitis.
• J01.0 Acute maxillary sinusitis.
• J01.1 Acute frontal sinusitis.
• J01.2 Acute ethmoid sinusitis.
• J01.3 Acute sphenoidal sinusitis.
• J01.4 Acute pansinusitis.
• JOT.5 Other acute sinusitis.
• J01.6 Acute sinusitis, unspecified.

Epidemiology of acute sinusitis

Acute sinusitis accounts for 30-35% of all cases of upper respiratory tract infections. Acute sinusitis is recorded starting from the neonatal period (acute ethmoiditis), but more often at the age of 3-6 years (acute ethmoiditis and acute maxillary sinusitis). Acute frontal sinusitis and acute sphenoidal sinusitis, and especially pansinusitis, are observed less frequently.

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Causes of Acute Sinusitis

In the etiology of acute sinusitis in children over 3-4 years of age, the leading role is played by pneumococci (up to 40% of cases), followed by non-typeable Haemophilus influenzae (up to 10-12% of cases), a slightly lesser role is played by Staphylococcus aureus and Staphylococcus epidermidis, Moraxella catarrhalis and pyogenic streptococcus.

In infants and young children, the etiology of acute sinusitis, which occurs as acute ethmoiditis and acute sinusitis, differs. In newborns and children in the first half of life, the leading role is played by Staphylococcus aureus and Staphylococcus epidermidis. The second most common are enteropathogenic bacilli such as Escherichia coli and Klebsiella. Pyogenic streptococcus can also be the cause of acute sinusitis.

What causes acute sinusitis in children?

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Symptoms of acute sinusitis

In newborns and infants, the disease in the form of ethmoiditis develops rapidly and is severe. The catarrhal form is almost never diagnosed, since the disease turns into a purulent form within a few hours. General symptoms prevail over local ones: a sharp deterioration in the condition, hyperthermia, anxiety of the child, regurgitation, vomiting. The child's nasal breathing is impaired, and as a result, there is a refusal to eat. In addition, shortness of breath is noted, especially when the child is lying down, and the appearance of swelling in the area of the angle of the eye socket, discharge from the nose. By the end of the first - second day of the disease, swelling of the eye socket is noted, the eye is closed or half-closed, lacrimation and hyperemia appear.

Symptoms of acute sinusitis

Classification of acute sinusitis

Sinusitis is classified by the duration of the disease, the nature of the inflammation, the localization of the process and the severity of the course.

There are acute and recurrent sinusitis. Acute sinusitis includes diseases lasting up to 3 months. If acute sinusitis recurs 2-4 times a year, it is customary to talk about recurrent sinusitis.

Acute sinusitis can be catarrhal and purulent in nature.

In addition, acute sinusitis is differentiated depending on the localization of the inflammatory process. Acute sinusitis (acute maxillary sinusitis), acute frontal sinusitis (acute frontal sinusitis), acute ethmoiditis (acute ethmoidal sinusitis), acute sphenoiditis (acute sphenoidal sinusitis), and pansinusitis are distinguished.

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Diagnosis of acute sinusitis

When assessing the clinical picture of the disease, diagnostically significant clinical criteria for acute sinusitis include:

• purulent discharge from the nose;
• flow of purulent discharge down the back wall of the pharynx;
• lack of effect from the administration of intranasal decongestants;
• drip syndrome.

Diagnosis of acute sinusitis

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Treatment of acute sinusitis

There is no special non-drug treatment for acute sinusitis, both catarrhal and purulent. The diet is normal. The regimen is extended, except for pansinusitis, when bed rest is prescribed for 5-7 days.

First of all, it is necessary to ensure drainage from the paranasal sinuses. For this, especially in case of catarrhal sinusitis, intranasal decongestants are used. In addition, local antibacterial or antiseptic drugs are indicated for catarrhal sinusitis. For this purpose, fusafungine (bioparox) in a spray is used in children over 2.5 years old, 2-4 sprays 4 times a day in each half of the nose for 5-7 days, or hexetidine (hexoral) in a spray is used, 1-2 sprays in each half of the nose 3 times a day, also for 5-7 days. Children under 2.5 years old are prescribed hexoral in drops, 1-2 drops 3-4 times a day in each half of the nose for 7-10 days.

How is acute sinusitis treated?