title: The management of sinusitis in patients infected with the human immunodeficiency virus (HIV).
abstract: As the Human Immunodeficiency Virus (HIV) has extended its influence across the United States, otolaryngologists have been increasingly called upon to manage its various head and neck manifestations. Sinusitis is a very prevalent, yet difficult, management problem in this patient population. The pathophysiology of sinusitis in this setting relates to altered helper T-lymphocyte function, an abnormal inflammatory response as well as increased IgE-mediated inflammation. Chronic HIV-related sinusitis is often due to Pseudomonas aeruginosa, Staphylococcus aureus, or anaerobic bacteria, and empiric antibiotic therapy must include these potential pathogens. Early cultures can facilitate organism-specific antibiotic therapy. Aggressive treatment with decongestants, topical nasal steroids, mucoevacuants and occasionally antihistamines should be included at maximal tolerated doses. When medical therapy fails, surgical drainage can be a safe and effective management option. Appropriately directed medical, and occasionally surgical, therapy can lead to a dramatic clinical response and provide an improved quality of life in this patient population.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, Ohio, USA.
authors.forename: T A
authors.initials: TA
authors.lastname: Tami
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000150:complications; D015703:Antigens, CD; D004322:Drainage; D004358:Drug Therapy; D006679:HIV Seropositivity / Q000150:complications*; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional; D012852:Sinusitis / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D013601:T-Lymphocytes
chemical_list: D015703:Antigens, CD