title: The significance of Streptococcus anginosus group in intracranial complications of pediatric rhinosinusitis.
abstract: OBJECTIVE
  To assess the significance of the Streptococcus anginosus group in intracranial complications of pediatric patients with rhinosinusitis.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Tertiary pediatric hospital.
  
  
  METHODS
  A 20-year review of medical records identified patients with intracranial complications resulting from rhinosinusitis. In the 50 cases identified, S anginosus was the most commonly implicated bacterial pathogen in 14 (28%). Documented data included demographics, cultured bacteria, immune status, sinuses involved, type of intracranial complication, otolaryngologic surgical and neurosurgical intervention, type and duration of antibiotics used, and resulting neurologic deficits. Complications and outcomes of cases of S anginosus group-associated rhinosinusitis were compared with those of other bacteria.
  
  
  METHODS
  The severity and outcomes of intracranial complications of pediatric rhinosinusitis due to S anginosus group bacteria compared with other bacteria.
  
  
  RESULTS
  Infection caused by the S anginosus group resulted in more severe intracranial complications (P = .001). In addition, patients with S anginosus group-associated infections were more likely to require neurosurgical intervention (P < .001) and develop long-term neurologic deficits (P = .02). Intravenous antibiotics were administered for a longer duration (P < .001) for S anginosus group-associated infections.
  
  
  CONCLUSIONS
  Rhinosinusitis associated with the S anginosus group should be considered a more serious infection relative to those caused by other pathogens. Streptococcus anginosus group bacteria are significantly more likely than other bacteria to cause more severe intracranial complications and neurologic deficits and to require neurosurgical intervention. A low threshold for intervention should be used for infection caused by this pathogen.
authors: Sections of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Calgary, Calgary, Alberta, Canada.
authors: Michael W
authors: MW
authors: Deutschmann
authors: Devon
authors: D
authors: Livingstone
authors: John J
authors: JJ
authors: Cho
authors: Otto G
authors: OG
authors: Vanderkooi
authors: James T
authors: JT
authors: Brookes
mesh_terms: D000038:Abscess / Q000382:microbiology / Q000628:therapy; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D020226:Cavernous Sinus Thrombosis / Q000382:microbiology / Q000628:therapy; D002493:Central Nervous System Diseases / Q000382:microbiology / Q000628:therapy; D002648:Child; D015331:Cohort Studies; D004724:Endoscopy / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D016920:Meningitis, Bacterial / Q000382:microbiology / Q000628:therapy; D019635:Neurosurgical Procedures / Q000706:statistics & numerical data; D015835:Ocular Motility Disorders / Q000209:etiology; D054517:Orbital Cellulitis / Q000382:microbiology / Q000628:therapy; D009916:Orbital Diseases / Q000382:microbiology / Q000628:therapy; D010243:Paralysis / Q000209:etiology; D059369:Pott Puffy Tumor / Q000382:microbiology / Q000628:therapy; D012189:Retrospective Studies; D012220:Rhinitis / Q000382:microbiology* / Q000628:therapy; D012737:Sex Factors; D012852:Sinusitis / Q000382:microbiology* / Q000628:therapy; D013290:Streptococcal Infections / Q000150:complications* / Q000628:therapy; D034366:Streptococcus anginosus; D014786:Vision Disorders / Q000209:etiology
chemical_list: D000900:Anti-Bacterial Agents