The role of Chlamydia pneumoniae infection in children with chronic sinusitis.
BACKGROUND
Chlamydia pneumoniae infection is a frequent cause of lower respiratory disease in both adults and children. However, its role in upper respiratory disease, including sinusitis, is less clear.


OBJECTIVE
To determine the role of infection with C. pneumoniae in chronic sinusitis in children.


METHODS
Prospective collection of specimens.


METHODS
Tertiary care academic medical center.


METHODS
Children with clinical and radiologic evidence of chronic sinusitis unresponsive to medical management undergoing adenoidectomy, maxillary sinus lavage, or endoscopic sinus surgery for treatment. Intervention Nasopharyngeal and middle meatal swabs and portions of surgical specimens were obtained and cultured for C. pneumoniae.


RESULTS
Specimens were obtained from 20 children (14 boys and 6 girls) aged 3 through 16 years. Thirteen bilateral endoscopic ethmoidectomies with maxillary antrostomies, 10 adenoidectomies, and 3 bilateral maxillary sinus lavages were performed. Chlamydia pneumoniae was isolated from the nasopharyngeal swab and adenoid tissue of 1 child (aged 6 years); however, his middle meatal swabs and maxillary sinus aspirates were negative. After 10 days of treatment with clarithromycin, repeat nasopharyngeal cultures were negative for C. pneumoniae.


CONCLUSIONS
With the use of sensitive culture methods, C. pneumoniae was not isolated from sinus specimens of children enrolled in this study. This preliminary study suggests that C. pneumoniae does not play a significant role in chronic sinusitis in children.
Department of Otolaryngology-Division of Infectious Diseases, State University of New York Downstate Medical Center, Brooklyn 11203, USA. cultura@yahoo.com
Anthony
A
Cultrara
Nira A
NA
Goldstein
Alexander
A
Ovchinsky
Tamara
T
Reznik
Patricia M
PM
Roblin
Margaret R
MR
Hammerschlag
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D023521:Chlamydophila Infections / Q000382:microbiology*; D016993:Chlamydophila pneumoniae / Q000302:isolation & purification*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D009305:Nasopharynx / Q000382:microbiology; D010256:Paranasal Sinuses / Q000382:microbiology; D011446:Prospective Studies; D012852:Sinusitis / Q000382:microbiology* / Q000601:surgery