Acute Bacterial Sinusitis in Children

Division of Infectious Diseases, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA.
New England Journal of Medicine (Impact Factor: 55.87). 09/2012; 367(12):1128-34. DOI: 10.1056/NEJMcp1106638
Source: PubMed


A 4-year-old girl who attends day care presents with rhinorrhea and a daytime cough that have been present for 12 days. She has not had fever, but her appetite is poor and her interest in activities is diminished. On physical examination, there is clear rhinorrhea present in the nasal passages. The remainder of the examination is unremarkable. Should she be treated with an antibiotic?

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    • "Although uncommon (the reported incidence in specialised tertiary centres is 0.3-1.3 cases per month) [16], the disease processes may lead to serious complications, including vision loss and a predisposition for life-threatening events such as cavernous sinus thrombophlebitis or other intra-cranial complications [3,4,6,7]. The incidence of associated complications was especially high in the pre-antibiotic era, with 17% mortality due to meningitis and a 20% rate of blindness [8], the rates of vision loss and overall mortality are now respectively 11% and 2.5% [17]. "
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