October Week 2

Sinusitis

Articles:

1. Sinusitis. Pediatrics in Review. 2006

2. Acute Bacterial Sinusitis in Children. NEJM. 2012.

Case/Discussion:

A 5-year old boy presents with a runny nose and a cough for 14 days. He attends daycare and is afebrile. He is less playful than usual and his PO intake has decreased although his urine output is adequate. On physical exam, clear rhinorrhea is noted.

1. What is the temporal difference between acute sinusitis and chronic sinusitis?

2. What are the 3 typical presentations of acute sinusitis?

3. Name the 4 pairs of sinus cavities

4. Which sinus cavities are fully formed at birth?

5. Which sinus cavities are the last to develop (not fully formed until early teens)?

6. What is the most important tool in diagnosing acute sinusitis?

7. T/F: Imaging is NOT recommended for the diagnosis & management of uncomplicated sinusitis.

8. What is the gold standard for diagnosis of sinusitis (not routinely done)?

9. What are the 2 most common predisposing factors for acute bacterial sinusitis?

10. What are the top 3 bacterial pathogens causing sinusitis (hint: same pathogens involved in acute otitis media)?

11. What is the first line treatment for acute bacterial sinusitis?

12. What are some complications of sinusitis?