Diagnosis and management of acute rhinosinusitis in children.
Rhinosinusitis is a common disease in children that is often overlooked. The clinical symptoms of acute rhinosinusitis are nasal blockage or congestion, nasal discharge or postnasal drip (often mucopurulent), facial pain, headache, and reduction in/loss of smell. Direct vision by nasal fibroendoscopy may aid the diagnosis. Regarding imaging criteria, recent consensus documents state that plain sinus x-rays are of limited utility, and CT remains the technique of choice, particularly in children with complications or very persistent or recurrent infections that are unresponsive to medical management. Antibiotics are the primary form of medical treatment for acute bacterial rhinosinusitis, but they should be used when acute bacterial rhinosinusitis presents as persistent or severe disease. This will minimize the number of children with uncomplicated viral upper respiratory tract infections who are treated with antimicrobials. Topical corticosteroids may reduce nasal edema and improve ostial drainage and ventilation of the sinus.
Leo
Gualtiero
G
Pediatric Allergy and Respiratory Pathophysiology Unit, Vittore Buzzi Children's Hospital, Istituti Clinici di Perfezionamento, Via Castelvetro 32, 20154 Milan, Italy. gualtiero.leo@icp.mi.it
Mori
Francesca
F
Incorvaia
Cristoforo
C
Barni
Simona
S
Novembre
Elio
E
D000208:Acute Disease; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D006801:Humans; D012220:Rhinitis / Q000175:diagnosis* / Q000188:drug therapy* / Q000276:immunology / Q000382:microbiology; D012852:Sinusitis / Q000175:diagnosis* / Q000188:drug therapy* / Q000276:immunology / Q000382:microbiology
D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents