Mycrobiology of sinusitis
A.Acute sinusitis The most commonly identified organisms in children with acute sinusitis are Streptococcus pneumoniae in 30% to 40%, Haemophilus influenzae in 20% to 25%, and Moraxella catarrhalis in 20%. In adults, S. pneumoniae and H. influenzae are the two leading causes of acute sinusitis, whereas Moraxella is unusual. Anaerobic organisms are primarily identified in cases of acute sinusitis originating from dental root infections, but are otherwise uncommon. Hospital-acquired sinusitis is most often seen as a complication of nasogastric tube placement, and is typically caused by gram-negative enteric organisms, such as Pseudomonas and Klebsiella species. B.Chronic sinusitis 1. Bacteria cultured from children with persistent symptoms are usually the same as those seen in acute disease. In children with more severe and protracted symptoms, anaerobic species (such as Bacteroides) and staphylococci are cultured more frequently. In adults with refractory symptoms, Staphylococcus epide...