Acute Sinusitis

Health Care
Health Care

Infection of the sinus mucosa with purulent of nasal (rhinitis, allergies, obstruction) or dental.

Can become chronic, especially in older children and adults.

Clinical signs:

– Association of pain and purulent rhinorrhea

Older children and adults:

– Periorbital pain in frontal sinusitis; pain in the face in case of maxillary sinusitis and / or ethmoidal.

– Purulent rhinorrhea the painful side, nasal obstruction and moderate fever.

– On examination:

• painful pressure from the front or face,

• purulent secretion in the middle meatus and inflammatory mucosa.

The causes are Haemophilus 5 years before influenzae and pneumococcus after.

Special form for infants and young children:

– Acute ethmoiditis: high fever, inflammatory edema of the lower eyelid and the bridge of the nose, purulent rhinorrhea.

– Infection spreading risk to the bone, orbit, meninges.

The causes are Haemophilus influenzae, pneumococci and staphylococci.


– Unblocking the nasopharynx by washing with sodium chloride 0.9% or Ringer’s lactate, 4-6 times / day.

– Pain and fever: paracetamol PO (see page 26).

– Antibiotic depending on severity:

amoxicillin PO: 80 mg / kg / day divided in 2 or 3 doses for 7 to 10 days

In case of allergy to penicillin:

erythromycin PO: 30 to 50 mg / kg / day divided in 2 or 3 doses for 7 to 10 days

– Tooth extraction if it is the cause, as antibiotics.

– If ethmoiditis infant, aggressive treatment is necessary:

ceftriaxone IM: 100 mg / kg / day in 2 divided doses for 10 days

or, failing that,

IV ampicillin 200 mg / kg / day in 3 divided to 4 injections until improvement and oral treatment with amoxicillin 100 mg / kg / day in 2 or 3 doses to complete 10 days of treatment

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