Emerging Issues in Head and Neck Infections

Part of the Emerging Infectious Diseases of the 21st Century book series (EIDC)

Sinusitis is a common disorder that is frequently diagnosed in clinical practice and has been diagnosed in more than 30 million people each year in the United States.1 Inflammation of the nasal and sinus mucosa can arise from various causes and leads to different sequelae. The term rhinosinusitis is more accurate than sinusitis as the nasal and sinus mucosae are contiguous but the latter is more commonly used and entrenched in medical parlance, thus will be used in this chapter. The three most common inciting factors or causes of sinus inflammation (sinusitis) are viral infections, allergies, and bacterial infections. Accumulating evidence over the past decade has indicated that most children and adults with symptoms of sinusitis are treated unnecessarily with antibiotics, as most cases are due to viral infection. This has contributed to the global increase in antibacterial resistance and exposes subjects to unnecessary side effects.


Tympanic Membrane Maxillary Sinus Chronic Sinusitis Otitis Medium With Effusion Acute Sinusitis 
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  1. 1.
    United States Department of Health and Human Services. (1987) National Health survey. Prevalence of Selected Chronic conditions, United States; 1983–85, Hyattsville, MD, US Department of Health and Human Services.Google Scholar
  2. 2.
    Kaliner, M.A., Osguthorpe, J.D., Fireman., O., Anon. J., Georgitis. J., Davis, M.L., Naclerio. R., Kennedy, D. (1997), Sinusitis: bench to bedside, Current findings, future directions. J. Allergy Clin. Immnol. 99(Suppl.): S829–S848.Google Scholar
  3. 3.
    Lusk, R.P., Stankiewiez, J.A. (1997), Pediatric Rhinosinusitis: Report of the Rhinosinusitis Task Force committee meeting. Otolaryngol. Head Neck Surg. 117(Suppl.): S53–S57.CrossRefPubMedGoogle Scholar
  4. 4.
    Anon, J.B., Jacobs, M.R., Poole, M.D., Ambrose, P.G., Benninger, M.S., Hadley, J.A., Craig, W.A., Allergy Health Partnership. (2004), Antimicrobial treatment guidelines for acute bacterial rhinosinusitis. Otolaryngol. Head Neck Surg. 130(Suppl 1): 1–45.Google Scholar
  5. 5.
    Blair, C., Nelson, M., Thompson, K., Boonlayangoor, S., Haney, L., Gabr, U., Baroody, F.M., Naclerio, R.M. (2001), Allergic inflammation enhances bacterial sinusitis in mice. J. Allergy Clin. Immnol. 108: 424–429.CrossRefGoogle Scholar
  6. 6.
    Anon, J.B. (2005) Current management of acute bacterial rhinosinusitis and the role of moxiflaxacin. Clin. Infect. Dis. 41(Suppl.): S167–S176.CrossRefPubMedGoogle Scholar
  7. 7.
    Lanza, D.C., Kennedy, D.W. (1997), Adult rhinosinusitis defined. Report of the Rhinosinusitis Task force Committee Meeting. Otolaryngol. Head Neck Surg. 117 (Suppl.): S1–S7.CrossRefPubMedGoogle Scholar
  8. 8.
    Lindbeck, M., Hjortdahl, P., Johnson, U. (1996), Use of symptoms, signs and blood tests to diagnose acute sinus infections in primary care: Comparison with computed tomography. Fam. Med. 28: 183–188.Google Scholar
  9. 9.
    Dowell, S.F., Schwartz, B., Phillips, W.R. (1998), Appropriate use of antibiotics for URI's in children. Part I. Otitis media and acute sinusitis, Am. Fam. Physician 58: 1113–1118.Google Scholar
  10. 10.
    Williams, J.W. Jr., Simel, D.L., Roberts, L, Samsa, G.P. (1992), Clinical evaluation for sinusitis. Making the diagnosis by history and physical examination. Ann Intern. Med. 117: 705–710.Google Scholar
  11. 11.
    Williams, J.W. Jr., Simel, D.R. (1993), Does this patient have sinusitis? Diagnosing acute sinusitis by history and physical examination. JAMA 270: 1242–1246.CrossRefPubMedGoogle Scholar
  12. 12.
    Brook, I., Gooch, W.M., Reiner, S.A., Jenkins, S.G., Sher, L., Pichichero, M.E., Yamauchi, T. (2000), Medical management of acute bacterial sinusitis. Recommendations of a clinical advisory committee on pediatric and adult sinusitis. Ann. Otol. Rhinol. Laryngol. 109: 2–20.Google Scholar
  13. 13.
    Gwaltney, J.M., Jr., Phillis, C.D., Miller, R.D., Riker, D.K. (1994), Computed tomographic study on the common cold: N. Engl. J. Med. 330: 25–30.CrossRefGoogle Scholar
  14. 14.
    The Institute for Clinical Systems Integration, (1998), Acute sinusitis in adults. Postgrad. Med.103: 154–156.Google Scholar
  15. 15.
    Willet, L.R., Carson, J.L., Williams, J.W. Jr. (1994), Current diagnosis and management of sinusitis. J. Gen. Intern. Med. 9: 38–45.CrossRefGoogle Scholar
  16. 16.
    International Rhinosinusitis Advisory Board, (1997), Infectious rhinosinusitis in adults: Classification, etiology and management. Ear Nose Throat J. 76(Suppl 72): 1–19.Google Scholar
  17. 17.
    Talbot, G.H., Kennedy, D.W., Schild, W.M., Gramto, K., for the Endoscopy Study Group. (2001), Rigid nasal endoscopy versus sinus puncture and aspiration for microbiologically documentation of acute bacterial maxillary sinusitis. Clin. Infect. Dis. 33: 1668–1675.CrossRefPubMedGoogle Scholar
  18. 18.
    Benninger, M.S., Ferguson, B.J., Hadley, J.A., Hamilos, D.L., Jacobs, M., Kennedy, D.W., Lanza, D.C., Marysle, B.F., Osguthorpe, J.P., Stankiewicz, J.A., Anon, J., Denneny, J., Emanuel, I., Levine, H. (2003), Adult Chronic rhinosinusitis: Definition diagnosis, epidemiology, and pathophysiology. Otolaryngol. Head Neck Surg. 129(Suppl 3): SI–S32.CrossRefGoogle Scholar
  19. 19.
    Calenoff, E., McMahan, J.T., Herzon, G.D., Kern, R.C., Ghadge, G.D., Hanson, D.G. (1993), Bacterial allergy in nasal polyposis; a new method for identifying specific Ig E. Arch. Otolaryngol. Head Neck Surg. 119: 830–836.PubMedGoogle Scholar
  20. 20.
    Schubert, M.S. (2001), A superantigen hypothesis for the pathogenesis of chronic hypertro-phic rhinosinusitis, allergic fungal sinusitis, and related disorders. Ann. Allergy Asthma Immunol. 81: 181–188.CrossRefGoogle Scholar
  21. 21.
    Gordts, F., Halewyck, S., Pierard, D., Clement, P.A.R., Kaufman, L. (2000), Microbiology of the middle meatus: a comparison between normal adults and children. J. Laryngol. Otol. 114: 184–188.CrossRefPubMedGoogle Scholar
  22. 22.
    Frederick, J., Braude, A.I. (1974), Anaerobic infection of the paranasal sinuses. N. Engl. J. Med. 290: 135–140.PubMedCrossRefGoogle Scholar
  23. 23.
    Brook, I. (2002), Anaerobic bacteria in upper respiratory tract and other head neck infection. Ann. Otol. Rhinol. Laryngol. 111: 430–440.PubMedGoogle Scholar
  24. 24.
    Doyle, P.W., Woodham, J.D. (1991), Bacterial flora in acute and chronic sinusitis. J. Clin. Neurol. 29: 2396–2399.Google Scholar
  25. 25.
    Finegold, S.M., Flynn, M.J., Rose, F.K., Jousimies-Somer, H., Jukielaszek, C., McTeague, M., Wexler, H.M., Bekowitz, E., Wynne, B. (2002), Bacteriologic findings associated with chronic bacterial maxillary sinusitis in adults. Clin. Infect. Dis. 35: 428–433.CrossRefPubMedGoogle Scholar
  26. 26.
    Keech, D.R., Romadan, H., Mathers. P. (2000), Analysis of aerobic bacterial strains found in chronic rhinosinusitis using the polymerase chain reaction. Otolaryngol. Head Neck Surg. 123: 363–367.CrossRefPubMedGoogle Scholar
  27. 27.
    Hickner, J.M., Barlett, J.G., Besser, R.E., Gonzales, R., Hoffman, M.A., Sande, M.A., American Academy of Family Physicians; American College of Physicians-American Society of Internal Medicine; Centers for Disease Control; Infectious Diseases Society of America. (2001), Principles of appropriate antibiotic use for acute rhinosinusitis in adults: background. Ann. Intern. Med. 134: 498–505.PubMedGoogle Scholar
  28. 28.
    Gwaltney, J.M., Scheld, W.M. Jr., Sande, M.A., Sydnor, A. (1992), The microbial etiology and antimicrobial therapy of adults with acute community-acquired sinusitis: a fifteen-year experience at the University of Virginia and review of other selected studies. J. Allergy Clin. Immunol. 90: 457–461.CrossRefPubMedGoogle Scholar
  29. 29.
    Jacobs, M.R., Felmingham, D., Appelbaum, P.C., Gruneberg, R.N. (2003), The Alexander project 1998–2000: susceptibility of pathogens isolated from community-acquired respiratory tract infection to commonly used antimicrobial agents. J. Antimicrobial. Chemother. 52: 229– 246.CrossRefGoogle Scholar
  30. 30.
    Zucher, D.R., Balk, E., Engels, E., Barza, M., Lau, J., Agency for Healthcare Research. (1999), Diagnosis and treatment of acute bacterial rhino-sinusitis. Evidence report /technolo-gy assessment no. 99-E016. Available at: www.ahrq.gov./chemi/sinussum.htm
  31. 31.
    Williams, J.W., Aguilar, C. Jr., Makela, M., Cornell, J., Hollman, D., Chiquette, E.: Cochrane Acute Respiratory Infections Group. (1997), Antibiotic therapy for acute sinusitis: a systemic literature review. In: Douglas, R., Bridges-Webb, C., Glasziou, P., Lozano, J., Steinhoff, M., Wang, E. (eds), Acute Respiratory Infections Module of the Cochrane Database of Systematic Reviews. The Cochrane Library, Oxford. Updates software.Google Scholar
  32. 32.
    deBock, G.H., Dekker, F.W., Stolk, J., Springer, M.P., Kiwit, J., van Houwelingen, J.C. (1997), Antimicrobial treatment of acute maxillary sinusitis: a meta-analysis. J. Clin. Epidemiol. 50: 881–890.CrossRefGoogle Scholar
  33. 33.
    Karchmer, A.W. (2004), Increased antibiotic resistance in respiratory tract pathogen: PROTECT US- an update Clin. Infect Dis. 39(Suppl.): S142–S150.Google Scholar
  34. 34.
    Williams, J.W., Aguilar, C. Jr., Cornell, J., Chiquette, E., Dolor, R.J., Makela, M., Holleman, D.R., Simel, D.L., Cochrane Acute Respiratory Infections Group. (2005), Antibiotics for acute maxillary sinusitis. Cochrane database Systematic Reviews. 4.Google Scholar
  35. 35.
    Winther, B., Vickery, C.L., Gross, C.W., Hendley, J.O. (1996), Microbiology of the maxillary sinus in adults with chronic sinus disease. Am. J. Rhino. 10: 347–350.CrossRefGoogle Scholar
  36. 36.
    Kennedy, D.W., (1992), Progrnostic factors, outcome and staging in ethmoid sinus surgery. Laryngoscope 102: 1–18.PubMedGoogle Scholar
  37. 37.
    Thakar, A.W., Sanker, C., Dhiwaker, M., Bahadur, S., Dahiya, S. (2004), Allergic fungal sinusitis: Expanding the clinicopathologic spectrum. Otolaryngol. Head Neck Surg. 130: 209–216.CrossRefPubMedGoogle Scholar
  38. 38.
    Chonmaitree, T., Howie, V.M., Truant, A.L., (1986), Presence of respiratory viruses in middle ear fluids and nasal wash specimens from children with acute otitis media. Pediatrics 77: 698–702.PubMedGoogle Scholar
  39. 39.
    Klein, B.S., Dallette, E.R., Volken, R.H. (1982), The role of respiratory syncytial virus and other viral pathogens in acute otitis media. J. Pediater. 101: 16–20.CrossRefGoogle Scholar
  40. 40.
    Klein J.O., (2000), Otitis externa, Otitis media and mastoditis. In: Mandell, G.L., Bennett, J. E., Dolin, R. (eds), Principles and Practice of Infectious Diseases, Fifth Edition, Churchill Lewingstone, Philadelphia, pp. 669–675.Google Scholar
  41. 41.
    Pichichero, M.E. (2000), Acute otitis media: part I, Improving diagnostic accuracy. Am. Fam. Phys. 61: 2051–2056.Google Scholar
  42. 42.
    Rothman, R., Owens, T., Simel, D.L. (2003), Does this child have acute otitis media? JAMA 290: 1633–1640.CrossRefPubMedGoogle Scholar
  43. 43.
    Howie, V.M., Ploussard, J.H. (1969), Bacteriology of middle ear exudates during antimicrobial therapy in otitis media. Pediatrics: 44: 940–944.PubMedGoogle Scholar
  44. 44.
    Rosenfeld, R.M., Vertrees, J.E., Carr, J., Cipolle, R.J., Urden, D.L., Giebink, G.S., Canafax, D.M. (1994), Clinical efficacy of antimicrobial drugs for acute otitis media: meta-analysis of 5400 children from thirty three randomized trials. J. Pediatr. 124: 355–367.CrossRefPubMedGoogle Scholar
  45. 45.
    Del Mar, C., Glasziou, P., Hayem, M. (1997), Are antibiotics indicated as initial treatment for children with acute otitis media? A meta-analysis. BMJ. 314: 1526–1529.PubMedGoogle Scholar
  46. 46.
    Glasziou, P.P., Delmar, C.B., Hayem, M., Sanders, S.L. (2006), Antibiotics for acute otitis media in children. Cochrane Database Sys. Rev. 4: CD000219.Google Scholar
  47. 47.
    Rosenlfeld, R.M., Kay, D. (2003), Natural history of untreated otitis media, In: Rosenfeld, R. M., Bluestone C.D. (eds). Evidence Based Otitis Media, 2nd edition/BC Decker, Hamilton, ON, pp. 180–198.Google Scholar
  48. 48.
    Marcy, M., Takata, G., Chan, L.S., Shekelle, P., Mason, W., Wachsman, L., Ernst, R., Hay, J. W., Corley, P.M., Morphew, M.S., Ramieone, E., Nicholson, C. (2001), Management of acute otitis media. Evidence report/technology assessment no. 15. Rockville, MD, Agony for Healthcare Research and Quality, AHRQ Publication.no. 01-E010Google Scholar
  49. 49.
    Appleman, C.L., Van Balen, F.A., Vandelisdonk, E.H., van Weert, H.C., Eizenga, W.H. (1999), Otitis media acute, NHG- standaard Eerste herziening [in Dutch]. Huisarts Wet. 42: 362–366.Google Scholar
  50. 50.
    van Buchem, F.L., Dunk, J.H., van't Hof., M.A. (1981), Therapy of acute otitis media: myrngotomy, antibiotics or neither? A double blind study in children. Lancet 2: 882–887.Google Scholar
  51. 51.
    van Buchem, F.L., Peeters, M.F., van't Hof, M.A. (1985), Acute otitis media: a new treatment strategy. Br Med. J. (Clin. Res. Ed) 290: 1033–1037.CrossRefGoogle Scholar
  52. 52.
    Little, P., Gould, C., Williamson, I., Moore, M., Warner, G., Dunleavey, J. (2001), Pragmatic randomized controlled trail of two prescribing strategies for childhood acute otitis media. BMJ 322: 336–342.CrossRefPubMedGoogle Scholar
  53. 53.
    Little, P., Gould, C., Moore, M., Warner, G., Dunleavey, J., Williamson, I., (2002), Predictors of poor outcome and benefits from antibiotics in children with acute otitis media: pragmatic randomized trial. BMJ 325: 22.CrossRefPubMedGoogle Scholar
  54. 54.
    Kaleida, P.H., Casselbrant, M.L., Rockette, H.E., Paradise, J.L., Bluestone, C.D., Blatter, M. M., Reisinger, K.S., Wald, E.R, Supance, J.S. (1991), Amoxicillin or myringotomy or both for acute otitis media: Results of a randomized clinical trial. Pediatrics 87: 466–474.PubMedGoogle Scholar
  55. 55.
    Damoiseaux, R.A., van Balen F.A., Hoes, A.W., Verhey, T.J., de Melker, R.A. (2000), Primary care based randomized double blind trail of amoxicillin versus placebo for acute otitis media in children aged under 2 years. BMJ 320: 350–354.CrossRefPubMedGoogle Scholar
  56. 56.
    Le Saux, N., Gaboury, I., Baird, M., Klassen, T.P., MacCormick, J., Blanchard, C., Pitters, C., Sampson, M., Moher, D. (2005), A randomized, double-blind, placebo-controlled non-inferiority trial of amoxicillin for clinically diagnosed acute otitis media in children 6 months to 5 years of age. CMAJ 172: 335–341.PubMedGoogle Scholar
  57. 57.
    Damoiséaux, R.A.M.J. (2005), Antibiotic treatment for acute otitis media: time to think again (editorial). CMAJ 172: 657–658.Google Scholar
  58. 58.
    van Zuijlen, D.A., Schilder, A.G., van Balen, F.A., Hoes, A.W. (2001), National differences in acute mastoiditis; relationship in prescribing patterns of antibiotics for acute otitis media? Pediatr. Infect. Dis. 20: 140–144.CrossRefGoogle Scholar
  59. 59.
    Kilpi, T., Anttila, M., Kallio, M.J., Peltola, H. (1991), Severity of childhood bacterial meningitis: duration of illness before diagnosis. Lancet 338: 406–409.CrossRefPubMedGoogle Scholar
  60. 60.
    Black, S., Shinefield, H., Fireman, B., Lewis, E., Ray, P., Hansen, J.R., Elvin, L., Ensor, K.M., Haikell, J., Siber, G., Malinoski, F., Madove, D., Chang, I., Kohberger, R., Watson, W., Austrian, R., Edwards, K. (2000), Efficacy, safety and immunogenicity of heptavalent pneu-mococcal conjugate vaccine in children. Pediatr. Infect. Dis. 19: 187–195.CrossRefGoogle Scholar
  61. 61.
    American Academy of Pediatrics and American Academy of Family Physicians. (2004), Diagnosis and management of acute otitis media. Pediatrics 113: 1451–1465.CrossRefGoogle Scholar
  62. 62.
    Seppälä, H., Klaukka, T., Vuopio-Varkila, J., Muotiala, A., Helemus, H., Lager, K., Huovi-nen, P., For the Finnish Study Group for Antimicrobial Resistance. (1997), The effect of changes in the consumption of macrolide antibiotics on erythromycin resistance in group A. Streptococci in Finland. N. Engl. J. Med. 337: 441–446.CrossRefGoogle Scholar
  63. 63.
    Spiro, D.M., Tay, K.-Y., Arnold, D.H., Dziura, J.D., Baker, M.D., Shapiro, E.D. (2006) Wait-and-see prescription for the treatment of acute otitis media. JAMA 296: 1235–1241.CrossRefPubMedGoogle Scholar
  64. 64.
    Eskola, J., Kilpi, T., Palma, A., Jokinen, J., Haapakoski, J., Herva, E., Takala, A., Käythy, H., Karma, P., Kohberger, R., Siber, G., Mäkelä, H., For the Finnish Otitis Media Study Group. (2001), Efficacy of a pneumococcal conjugate vaccine against acute otitis media. N. Engl. J. Med. 344: 403–409.CrossRefPubMedGoogle Scholar
  65. 65.
    Veenhoven, R., Bogaert, D., Uniterawal, C., Brouwer, C., Kiezebrink, H., Bruin, J., Ijzerman, E., Hermans, P., de Groot, R., Zegers, B., Kuis, W., Rifkers, G., Schilder, A., Sanders, E. (2003), Effect of conjugate vaccine followed by polysaccharide pneumococcal vaccine on recurrent otitis media. Lancet 361: 2189–2195.CrossRefPubMedGoogle Scholar
  66. 66.
    Veenhoven, R.H., Bogaert, D., Schilder, A.G.M., Rifkers, G.T., Uiterwaal, C.S.P.M., Kiezeb-rink, H.H., Van Kempen, M.J.P., Dhooge, I. J., Bruin, J., IJzeerman, E.P.F., de Groot, R., Kuis, W., Hermans, P.W.M., Sanders, E.A.M. (2004), Nasopharyngeal pneumococcal carriage after combined pneumococcal conjugate and polysaccharide vaccination in children with a history of recurrent acute otitis media. Clin. Infect. Dis. 39: 911–919.CrossRefPubMedGoogle Scholar
  67. 67.
    Ghaffer, F., Barton, T., Lozano, J., Muniz, L.S., Huks, P., Gan, V., Ahmad, N., McCracken Jr., G.H. (2004), Effect of the 7-valent pneumococcal conjugate vaccine on nasopharyngeal colonization by Streptococcus pneumoniae in the first 2 years of life. Clin. Infect. Dis. 39: 930–938.CrossRefGoogle Scholar
  68. 68.
    McEllistrem, M.C., Adams, J.A., Patel, K., Mendelsolm, A.B., Kaplan, S.L., Brodley, J.S., Schitze, G.E., Kim, K.S., Mason, E.O., Wald, E.R. (2005), Acute otitis media due to penicil-lin-nonsusceptible Streptococcus pneumoniae before and after introduction of the pneumo-coccal conjugate vaccine. Clin. Infect. Dis. 40: 1738–1744.CrossRefPubMedGoogle Scholar

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