Whymark Andrew D, Crampsey David P, Fraser Lyndsay, Moore Philip, Williams Craig, Kubba Haytham
Institution Department of Paediatric Otolaryngology, Head and Neck Surgery, Royal Hospital for Sick Children, Yorkhill, Glasgow, UK.
Otolaryngol Head Neck Surg. 2008 Mar;138(3):307-10. doi: 10.1016/j.otohns.2007.10.029.
Epistaxis is very common in children but its cause remains unknown. We postulate that nasal colonization with Staphylococcus aureus leads to inflammation, crusting, and ultimately new vessel formation.
A prospective case-control study.
Sixty-seven children were recruited, 42 with epistaxis (22 had crusting in the nasal vestibule; 20 did not) and 25 control subjects. A microbiology swab was taken from the anterior nasal cavity of each child.
All groups were equally likely to have a positive culture. S aureus was more common in the epistaxis group (P = 0.008) compared with the control group. There was no difference in the prevalence of S aureus between crust and noncrust groups. Epistaxis patients were much less likely to have isolates of respiratory pathogens or a skin commensal.
Children with epistaxis are more likely to have nasal colonization with S aureus than controls. Our data would support the hypothesis that S aureus replaces existing nasal flora and causes inflammation and new vessel formation.
鼻出血在儿童中非常常见，但其病因尚不清楚。我们推测金黄色葡萄球菌在鼻腔的定植会导致炎症、结痂，并最终形成新的血管。
一项前瞻性病例对照研究。
招募了67名儿童，其中42名患有鼻出血（22名鼻前庭有结痂；20名没有），25名作为对照。从每个儿童的前鼻腔采集微生物拭子。
所有组培养结果呈阳性的可能性相同。与对照组相比，金黄色葡萄球菌在鼻出血组中更为常见（P = 0.008）。结痂组和非结痂组之间金黄色葡萄球菌的患病率没有差异。鼻出血患者分离出呼吸道病原体或皮肤共生菌的可能性要小得多。
鼻出血儿童鼻腔定植金黄色葡萄球菌的可能性比对照组更大。我们的数据支持这样的假设，即金黄色葡萄球菌取代了现有的鼻腔菌群并导致炎症和新血管形成。
