title: Childhood epistaxis and nasal colonization with Staphylococcus aureus.
abstract: OBJECTIVE
  Epistaxis is very common in children but its cause remains unknown. We postulate that nasal colonization with Staphylococcus aureus leads to inflammation, crusting, and ultimately new vessel formation.
  
  
  METHODS
  A prospective case-control study.
  
  
  METHODS
  Sixty-seven children were recruited, 42 with epistaxis (22 had crusting in the nasal vestibule; 20 did not) and 25 control subjects. A microbiology swab was taken from the anterior nasal cavity of each child.
  
  
  RESULTS
  All groups were equally likely to have a positive culture. S aureus was more common in the epistaxis group (P = 0.008) compared with the control group. There was no difference in the prevalence of S aureus between crust and noncrust groups. Epistaxis patients were much less likely to have isolates of respiratory pathogens or a skin commensal.
  
  
  CONCLUSIONS
  Children with epistaxis are more likely to have nasal colonization with S aureus than controls. Our data would support the hypothesis that S aureus replaces existing nasal flora and causes inflammation and new vessel formation.
authors.affiliation: Institution Department of Paediatric Otolaryngology, Head and Neck Surgery, Royal Hospital for Sick Children, Yorkhill, Glasgow, UK.
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Whymark
authors.forename: David P
authors.initials: DP
authors.lastname: Crampsey
authors.forename: Lyndsay
authors.initials: L
authors.lastname: Fraser
authors.forename: Philip
authors.initials: P
authors.lastname: Moore
authors.forename: Craig
authors.initials: C
authors.lastname: Williams
authors.forename: Haytham
authors.initials: H
authors.lastname: Kubba
mesh_terms: D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004844:Epistaxis / Q000382:microbiology*; D006801:Humans; D008297:Male; D009666:Nose / Q000382:microbiology*; D011446:Prospective Studies; D013211:Staphylococcus aureus / Q000302:isolation & purification*