What causes acute sinusitis in children?
Last reviewed: 19.10.2021
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In the etiology of acute sinusitis, pneumococci play a leading role in children older than 3-4 years (up to 40% of cases), followed by an unidentifiable hemophilic rod (up to 10-12% of cases), a somewhat lesser role is played by golden and epidermal staphylococcus, Moraxella catarrhalis and pyogenic streptococcus .
In infants and young children, the etiology of acute sinusitis, which proceeds in the form of acute etmoiditis and acute maxillary sinusitis, differs. The newborn and children of the first half of life are led by golden and epidermal staphylococci. The second most frequent place is occupied by such enteropathogenic bacilli as E. Coli and Klebsiella. The cause of acute sinusitis can also be pyogenic streptococcus. Pneumococcus, hemophilic rod and morocella catarrhis at this age are practically not found because of the passively transmitted by the mother of the child immunity to these pathogens. Only by the year of their role as a cause of acute sinusitis gradually increases and after 2-3 years they lead as causative agents of acute sinusitis.
At the age of 6-7 months and up to 4-5 years respiratory viruses - rhinoviruses, enteroviruses, parainfluenza viruses and respiratory syncytial viruses (PC viruses) play an important role in the etiology of acute sinusitis.
The pathogenesis of acute sinusitis
Respiratory viruses and bacteria, causing inflammation of the mucous membrane of the nasal cavity, contribute to reducing local anti-infection protection and by swelling of the mucous membrane of the nasal cavity cause obturation of the passage and accumulation of exudate in the nasal cavity. Infringement of the exudate passage is also promoted by thorns and crests of the nasal septum, hypertrophy of the middle and lower nasal concha, hyperplasia of the mucosa and polyps.
All this leads to a violation of the ventilation of the paranasal sinuses. Violation of the passage of exudate serves as a factor contributing to the rapid expansion of bacterial microflora and the transition to a purulent process.