Acute bacterial sinusitis

Background

• See also nosocomial sinusitis and invasive fungal sinusitis

Microbiology

• Streptococcus pneumoniae (most common; 41% in adults and children)
• Non-typable Haemophilus influenzae (35% in adults, 27% in children)
• Moraxella catarrhalis (4% in adults, 22% in children)
• Streptococci (7% in adults and children)
• Anaerobes (7% in adults)
• Staphylococcus aureus (3% in adults)

Risk Factors

• Systemic factors
  • Viral upper respiratory infection
  • Allergic rhinitis and asthma
  • Cystic fibrosis
  • Immune disorders including agammaglobulinemia, HIV, and chronic granulomatous disease
  • Ciliary dyskinesia
  • Tobacco smoke
• Mechanical factors: choanal atresia, cleft palate, deviated septum, nasal polyps, foreign body, tumour, ethmoid bullae
• Local factors: facial trauma, swimming and diving, rhinitis medicamentosa, nasal intubation