2022 Volume 43 Issue 1 Pages 70-76
We present the first clinical report of pediatric acute maxillary sinusitis detected Chlamydophila pneumoniae (C. pneumoniae) from maxillary sinus fluid. Acute rhinosinusitis is a common complication of upper respiratory tract inflammation in children. However, causative microorganisms remain unclear. We performed puncture and irrigation of maxillary sinus for investigation and treatment in 36 children (ages 5–14 years) with severe or persistent acute rhinosinusitis and detected respiratory bacteria in the sinus fluid using PCR. C. pneumoniae was detected in 4 cases (11%). The four cases were aged 8–10 years and composed of three boys and a girl. Among the cases, only C. pneumoniae was detected from 3 cases without fever, while C. pneumoniae and H. infuenzae were detected from one case with fever. There is a possibility that C. pneumoniae is one of causative bacteria of acute rhinosinusitis in children. The data suggest that C. pneumoniae, which accounts for about 10% of severe or persistent pediatric acute rhinosinusitis, is found frequently in patients aged 8–10 years and causes fever rarely unless the patient is coinfected by other microorganisms. Penicillins and cephalosporins, which are antibiotics commonly used for treatment of acute rhinosinusitis in children, are ineffective against C. pneumoniae. In treatment of acute rhinosinusitis in children, we need to consider that C. pneumoniae is a possible causative bacterium in persistent acute rhinosinusitis especially unresponsive to penicillin and cephalosporins.
