The Journal of Medical Microbiology, Vol 45, Issue 5 372-375, Copyright © 1996 by Society for General Microbiology

JOURNAL ARTICLE

Microbiology of the transition from acute to chronic maxillary sinusitis

I. Brook, E. H. Frazier and P. A. Foote
Department of Pediatrics, Georgetown University, Alachua General Hospital, Gainesville, FL, USA.

Repeated aspirations of sinus secretions by endoscopy was performed in five patients over a period of 34-50 days and, ultimately, surgical drainage was done in three who presented with acute maxillary sinusitis that did not respond to antimicrobial therapy and became chronic. The aspirates were cultured for aerobic and anaerobic bacteria. Most of the bacteria isolated from the first culture were aerobic or facultative bacteria: Streptococcus pneumoniae (three isolates), Haemophilus influenzae non-type-b (two) and Moraxella catarrhalis (one). Three of these cultures yielded bacteria that were resistant to the antimicrobial agents prescribed for treatment. Failure to respond to therapy was associated with the emergence of resistant aerobic and anaerobic bacteria in subsequent aspirates. These organisms included Fusobacterium nucleatum, pigmented Prevotella and Porphyromonas spp. and Peptostreptococcus spp. Eradication of the infection was achieved in all instances following the administration of antimicrobial agents effective against these bacteria, and in three instances by surgical drainage. This study illustrates the microbial dynamics of maxillary sinusitis that did not respond to antimicrobial therapy.

This article has been cited by other articles:

				I. Brook, P. A. Foote, and J. N. Hausfeld Increase in the frequency of recovery of meticillin-resistant Staphylococcus aureus in acute and chronic maxillary sinusitis J. Med. Microbiol., August 1, 2008; 57(8): 1015 - 1017. [Abstract] [Full Text] [PDF]

				I. Brook, P. A. Foote, and J. N. Hausfeld Frequency of recovery of pathogens causing acute maxillary sinusitis in adults before and after introduction of vaccination of children with the 7-valent pneumococcal vaccine. J. Med. Microbiol., July 1, 2006; 55(Pt 7): 943 - 946. [Abstract] [Full Text] [PDF]

				I. Brook and A. E. Gober Antimicrobial resistance in the nasopharyngeal flora of children with acute maxillary sinusitis and maxillary sinusitis recurring after amoxicillin therapy J. Antimicrob. Chemother., February 1, 2004; 53(2): 399 - 402. [Abstract] [Full Text] [PDF]

				E. J. C. Goldstein, D. M. Citron, and C. V. Merriam Comparative In Vitro Activities of Amoxicillin-Clavulanate against Aerobic and Anaerobic Bacteria Isolated from Antral Puncture Specimens from Patients with Sinusitis Antimicrob. Agents Chemother., March 1, 1999; 43(3): 705 - 707. [Abstract] [Full Text]