Infection of the sinus mucosa with purulent of nasal (rhinitis, allergies, obstruction) or dental.
Can become chronic, especially in older children and adults.
Clinical signs:
– Association of pain and purulent rhinorrhea
Older children and adults:
– Periorbital pain in frontal sinusitis; pain in the face in case of maxillary sinusitis and / or ethmoidal.
– Purulent rhinorrhea the painful side, nasal obstruction and moderate fever.
– On examination:
• painful pressure from the front or face,
• purulent secretion in the middle meatus and inflammatory mucosa.
The causes are Haemophilus 5 years before influenzae and pneumococcus after.
Special form for infants and young children:
– Acute ethmoiditis: high fever, inflammatory edema of the lower eyelid and the bridge of the nose, purulent rhinorrhea.
– Infection spreading risk to the bone, orbit, meninges.
The causes are Haemophilus influenzae, pneumococci and staphylococci.
Treatment:
– Unblocking the nasopharynx by washing with sodium chloride 0.9% or Ringer’s lactate, 4-6 times / day.
– Pain and fever: paracetamol PO (see page 26).
– Antibiotic depending on severity:
amoxicillin PO: 80 mg / kg / day divided in 2 or 3 doses for 7 to 10 days
In case of allergy to penicillin:
erythromycin PO: 30 to 50 mg / kg / day divided in 2 or 3 doses for 7 to 10 days
– Tooth extraction if it is the cause, as antibiotics.
– If ethmoiditis infant, aggressive treatment is necessary:
ceftriaxone IM: 100 mg / kg / day in 2 divided doses for 10 days
or, failing that,
IV ampicillin 200 mg / kg / day in 3 divided to 4 injections until improvement and oral treatment with amoxicillin 100 mg / kg / day in 2 or 3 doses to complete 10 days of treatment
