Effects of viral and bacterial infection on nasal and sinus mucosa.
There is still controversy over the role of viruses and bacteria in rhinologic infections, especially in sinusitis. Until recently it was not fully known whether the sinuses do in fact take part in the infectious process of a common cold (viral rhinitis). CT scans show that in the vast majority of otherwise healthy volunteers with a common cold, and without a previous history of recurrent or chronic sinusitis, the sinuses are involved; there was, however, in these individuals no typical symptomatology of acute sinusitis. A viral rhinitis alone does not seem to be able to elicit a "clinical" acute otitis. Bacteria determine the clinical picture and outcome of sinusitis. There is not much controversy about the role of bacteria in acute sinusitis, S. pneumoniae, H. influenzae, and M. catarrhalis being the most frequently involved. Much more conflicting reports are published about the normal flora of the sinuses, the role of anaerobes and the microbiology of chronic sinusitis. In this paper the mechanisms of viral and bacterial infection of the nasal and sinusal mucosa are described and the results of microbiological studies in sinusitis reported by other authors and our own group are discussed. It is postulated that, although bacteria are very important in acute sinusitis, their role in chronic sinusitis is minimal, the bacteria being opportunistic colonisers.
van Cauwenberge
P
P
Department of Otorhinolaryngology, University Hospital Ghent, Belgium.
Ingels
K
K
D001421:Bacteria, Anaerobic / Q000302:isolation & purification*; D005004:Ethmoid Bone / Q000382:microbiology* / Q000821:virology*; D006801:Humans; D008443:Maxillary Sinus / Q000382:microbiology* / Q000821:virology*; D009079:Mucociliary Clearance; D009297:Nasal Mucosa / Q000382:microbiology* / Q000821:virology*; D012220:Rhinitis / Q000382:microbiology* / Q000821:virology*; D012229:Rhinovirus / Q000302:isolation & purification*; D012852:Sinusitis / Q000382:microbiology* / Q000821:virology*