Wald E R, Milmoe G J, Bowen A, Ledesma-Medina J, Salamon N, Bluestone C D
N Engl J Med. 1981 Mar 26;304(13):749-54. doi: 10.1056/NEJM198103263041302.
We sought to correlate the clinical, radiographic, and bacteriologic findings in maxillary sinusitis in 30 children who had both upper-respiratory-tract symptoms and abnormal maxillary radiographs. Cough, nasal discharge, and fetid breath were the most common signs, but fever was present inconsistently. Facial pain or swelling and headache were prominent symptoms in older children. Bacterial colony counts of greater than or equal to 10(4) colony-forming units per milliliter were found in 34 of 47 sinus aspirates obtained from 23 children. The most common species recovered were Streptococcus pneumoniae, Haemophilus influenzae, and Branhamella catarrhalis. No anaerobic bacteria were isolated. Viruses were isolated from only two sinus aspirates. There was a poor correlation between the predominant species of bacteria recovered from either the nasopharyngeal or throat culture and the bacteria isolated from the sinus aspirate. This study demonstrates that children with both upper-respiratory-tract symptoms and abnormal sinus radiographs are likely to harbor bacteria in their sinuses, suggesting that such children have bacterial sinusitis.
我们试图对30名患有上呼吸道症状且上颌窦X光片异常的儿童的上颌窦炎的临床、影像学和细菌学检查结果进行相关性分析。咳嗽、流鼻涕和口臭是最常见的症状,但发热情况并不一致。面部疼痛或肿胀以及头痛是大龄儿童的突出症状。在从23名儿童获取的47份鼻窦抽吸取样中,有34份的细菌菌落计数大于或等于每毫升10⁴个菌落形成单位。分离出的最常见菌种为肺炎链球菌、流感嗜血杆菌和卡他莫拉菌。未分离出厌氧菌。仅从两份鼻窦抽吸取样中分离出病毒。从鼻咽部或咽喉培养物中分离出的主要菌种与从鼻窦抽吸取样中分离出的细菌之间相关性较差。这项研究表明,患有上呼吸道症状且鼻窦X光片异常的儿童鼻窦中可能存在细菌,提示这些儿童患有细菌性鼻窦炎。