Friedman R, Ackerman M, Wald E, Casselbrant M, Friday G, Fireman P
J Allergy Clin Immunol. 1984 Aug;74(2):185-9. doi: 10.1016/0091-6749(84)90284-7.
Signs, symptoms, and radiographic abnormalities of sinusitis are frequent in children with asthma; it is not known whether sinus inflammation is associated with bacterial infection or other mechanisms. Eight asthmatic patients with exacerbation of asthma despite bronchodilator therapy were studied after maxillary sinusitis was confirmed by radiographs. All had cough, wheezing, nasal stuffiness, rhinorrhea and were afebrile. Four patients had headaches, and two had facial pain. Maxillary sinus aspirates were obtained, and bacterial cultures were positive in five: Branhamella catarrhalis (2), nontypeable Hemophilus influenzae (2), Streptococcus pneumoniae (1). Nose and throat cultures did not correlate with sinus cultures. All patients received bronchodilators, and four of eight patients received steroids. All were treated for 14 to 28 days with antibiotics during which seven of the eight patients improved clinically including all with positive sinus cultures. Asthma-symptoms diary scores were kept by five; all demonstrated improvement. Pulmonary-function tests improved in five of seven patients after the antibiotic and asthma therapy including the four patients with positive cultures. Sinus radiographs cleared in three, improved in three, and were unchanged in two patients after antibiotic therapy.
鼻窦炎的体征、症状及影像学异常在哮喘儿童中很常见；目前尚不清楚鼻窦炎症是否与细菌感染或其他机制有关。在通过X光片确诊为上颌窦炎后，对8名尽管接受了支气管扩张剂治疗但哮喘仍加重的哮喘患者进行了研究。所有患者均有咳嗽、喘息、鼻塞、流涕，且无发热。4名患者有头痛，2名患者有面部疼痛。获取了上颌窦吸出物，5例细菌培养呈阳性：卡他布兰汉菌（2例）、不可分型流感嗜血杆菌（2例）、肺炎链球菌（1例）。鼻和咽培养结果与鼻窦培养结果不相关。所有患者均接受了支气管扩张剂治疗，8名患者中有4名接受了类固醇治疗。所有患者均接受了14至28天的抗生素治疗，在此期间，8名患者中有7名临床症状改善，包括所有鼻窦培养阳性的患者。5名患者记录了哮喘症状日记评分；所有患者症状均有改善。在接受抗生素和哮喘治疗后，7名患者中有5名肺功能测试结果有所改善，其中包括4名培养结果阳性的患者。抗生素治疗后，3例患者鼻窦X光片恢复正常，3例改善，2例无变化。
