Sinusitis and Pharyngitis

  • Barbara D. Reed


Sinusitis and pharyngitis are infectious syndromes commonly seen in the outpatient setting in which short- and long-term morbidity may be decreased by appropriate recognition and treatment. However, the clinical diagnosis of both entities relies on a high index of suspicion, an understanding of the limitations and benefits of the clinical examination and available tests, and an awareness of the treatment options available.


Chlamydia Trachomatis Rheumatic Fever Chronic Sinusitis Acute Rheumatic Fever Acute Sinusitis 
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  1. 1.
    Wald ER, Guerra N, Byers C. Upper respiratory tract infections in young children: duration of and frequency of complications. Pediatrics 1991;87:129–33.PubMedGoogle Scholar
  2. 2.
    Rachelefsky GS. Sinusitis in children—diagnosis and management. Clin Rev Allergy 1984;2:397–408.PubMedGoogle Scholar
  3. 3.
    Younis RT, Lazar RH. The approach to acute and chronic sinusitis in children. Ear Nose Throat J 1991;70:35–39.PubMedGoogle Scholar
  4. 4.
    Slavin RG. Sinusitis in adults. J Allergy Clin Immunol 1988;81: 1028–32.PubMedCrossRefGoogle Scholar
  5. 5.
    Evans FO Jr, Sydnor JB, Moore WE, et al. Sinusitis of the maxillary antrum. N Engl J Med 1975;293:735–9.PubMedCrossRefGoogle Scholar
  6. 6.
    Gwaltney JM Jr, Sydnor A Jr, Sande MA. Etiology and antimicrobial treatment of acute sinusitis. Ann Otol Rhinol Laryngol Suppl 1981;90:68–71.PubMedGoogle Scholar
  7. 7.
    Lusk RP, Lazar RH, Muntz RH. The diagnosis and treatment of recurrent and chronic sinusitis in children. Pediatr Clin North Am 1989;36:1411–21.PubMedGoogle Scholar
  8. 8.
    Wald ER, Milmoe GJ, Bowen A, Ledesma-Medina J, Salamon N, Bluestone CD. Acute maxillary sinusitis in children. N Engl J Med 1981;304:749–54.PubMedCrossRefGoogle Scholar
  9. 9.
    McAlister WH, Lusk R, Muntz HR. Comparison of plain radiographs and coronal CT scans in infants and children with recurrent sinusitis. AJR 1989;153:1259–64.PubMedCrossRefGoogle Scholar
  10. 10.
    Brook I. Bacteriologic features of chronic sinusitis in children. JAMA 1981;246:967–9.PubMedCrossRefGoogle Scholar
  11. 11.
    Karma P, Jokippi L, Sipila P, Luotonen J, Jokipii AM. Bacteria in chronic maxillary sinusitis. Arch Otolaryngol 1979;105:386–90.PubMedCrossRefGoogle Scholar
  12. 12.
    Brook I. Bacteriology of chronic maxillary sinusitis in adults. Ann Otol Rhinol Laryngol 1989;98:426–8.PubMedGoogle Scholar
  13. 13.
    Hamory BH, Sande MA, Sydnor A Jr, Seale DL, Gwaltney JM Jr. Etiology and antimicrobial therapy of acute maxillary sinusitis. J Infect Dis 1979;139:197–202.PubMedCrossRefGoogle Scholar
  14. 14.
    Reed BD, Huck W, Zazove P. Treatment of beta-hemolytic streptococcal pharyngitis with cefaclor or penicillin: efficacy and interaction with beta-lactamase producing organisms in the pharynx. J FamPract 1991;32:138–44.PubMedGoogle Scholar
  15. 15.
    Simon HJ, Sakai W. Staphylococcal antagonism to penicillin-G therapy of hemolytic streptococcal pharyngeal infection: effect of oxacillin. Pediatrics 1963;31:463–9.PubMedGoogle Scholar
  16. 16.
    Brook I, Yokum P. In vitro protection of group A beta-hemolytic streptococci from penicillin and cephalothin by Bacteroides fragilis. Chemotherapy 1983;29:18–23.PubMedCrossRefGoogle Scholar
  17. 17.
    Wald ER, Chiponis D, Ledesma-Medina J. Comparative effectiveness of amoxicillin and amoxicillin-clavulanate potassium in acute paranasal sinus infections in children: a double-blind, placebo-controlled trial. Pediatrics 1986;77:795–800.PubMedGoogle Scholar
  18. 18.
    Linden BE, Aguilar EA, Allen SJ. Sinusitis in the nasotracheally intubated patient. Arch Otolaryngol Head Neck Surg 1988; 114: 860–1.PubMedCrossRefGoogle Scholar
  19. 19.
    Wald ER. Sinusitis in children. N Engl J Med 1992;326:319–23.PubMedCrossRefGoogle Scholar
  20. 20.
    Sydnor A Jr, Gwaltney JM Jr, Cocchetto DM, Scheid M. Comparative evaluation of cefuroxime axetil and cefaclor for treatment of acute bacterial maxillary sinusitis. Arch Otolaryngol Head Neck Surg 1989;115:1430–3.PubMedCrossRefGoogle Scholar
  21. 21.
    Melen I, Friberg B, Andreasson L, Ivarsson A, Jannert M, Johansson CJ. Effects of phenylpropanolamine on ostial and nasal patency in patients treated for chronic maxillary sinusitis. Acta Otolaryngol (Stockh) 1986;101:494–500.CrossRefGoogle Scholar
  22. 22.
    Muntz HR, Lusk RP. Nasal antral windows in children: a retrospective study. Laryngoscope 1990;100:643–6.PubMedGoogle Scholar
  23. 23.
    Lusk RP, Muntz HR. Endoscopic sinus surgery in children with chronic sinusitis: a pilot study. Laryngoscope 1990;100:654–8.PubMedCrossRefGoogle Scholar
  24. 24.
    Gross CW, Lazar RH, Gurucharri MJ, et al. Pediatric functional endonasal sinus surgery. Otolaryngol Clin North Am 1989;22:733–8.PubMedGoogle Scholar
  25. 25.
    Davis WE, Templer JW, Lamear WR, Davis WE Jr, Craig SB. Middle meatus anstrostomy: patency rates and risk factors. Otolaryngol Head Neck Surg 1991;104:467–72.PubMedGoogle Scholar
  26. 26.
    Perrin JM, Charney E, MacWhinney JB Jr, McInerny TK, Miller RL, Nazarian LE Sulfisoxazole as chemoprophylaxis for recurrent otitis media: a double-blind crossover study in pediatric practice. N Engl J Med 1974;291:664–7.PubMedCrossRefGoogle Scholar
  27. 27.
    Melen I, Lindahl L, Andreasson L. Short and long-term treatment results in chronic maxillary sinusitis. Acta Otolaryngol (Stockh) 1986;102:282–90.CrossRefGoogle Scholar
  28. 28.
    Schaptert SM. National ambulatory medical care survey: 1989 summary, United States. Vital Health Stat [13] 1992;110:49.Google Scholar
  29. 29.
    Bisno AL. Group A streptococcal infections and acute rheumatic fever. N Engl J Med 1991;325:783–93.PubMedCrossRefGoogle Scholar
  30. 30.
    Kaplan EL, Top FH Jr, Dudding BA, Wannamaker LW. Diagnosis of streptococcal pharyngitis: differentiation of active infection from the carrier state in the symptomatic child. J Infect Dis 1971;123:490–501.PubMedCrossRefGoogle Scholar
  31. 31.
    Paradise JL. Etiology and management of pharyngitis and phar-yngotonsillitis in children: a current review. Ann Otol Rhinol Laryngol Suppl 1992;155:51–57.PubMedGoogle Scholar
  32. 32.
    Glezen WP, Clyde WA Jr, Senior RJ, Sheaffer CI, Denny FW. Group A streptococci mycoplasmas, and viruses associated with acute pharyngitis. JAMA 1967;202:455–60.PubMedCrossRefGoogle Scholar
  33. 33.
    Reed BD, Huck W, French T. Diagnosis of group A beta-hemolytic streptococcus using clinical scoring criteria, directigen 1–2–3 group A streptococcal test, and culture. Arch Intern Med 1990;150:1727–32.PubMedCrossRefGoogle Scholar
  34. 34.
    Breese BB. A simple scorecard for the tentative diagnosis of streptococcal pharyngitis. Am J Dis Child 1977;131:514–17.PubMedGoogle Scholar
  35. 35.
    Meier FA, Centor RM, Graham L Jr, Dalton HP. Clinical and microbiological evidence for endemic pharyngitis among adults due to group C streptococci. Arch Intern Med 1990;150:825–9.PubMedCrossRefGoogle Scholar
  36. 36.
    Komaroff AL, Aronson MD, Pass TM, Ervin CT, Branch WT Jr, Schachter J. Serologic evidence of Chlamydia and mycoplasmal pharyngitis in adults. Science 1983;222:927–9.PubMedCrossRefGoogle Scholar
  37. 37.
    Jones RB, Rabinovitch RA, Katz BP, et al. Chlamydia trachomatis in the pharynx and rectum of heterosexual patients at risk for genital infection. Ann Intern Med 1985;102:757–62.PubMedCrossRefGoogle Scholar
  38. 38.
    Huss H, Jungkind D, Amadio P, Rubenfeld I. Frequency of Chlamydia trachomatis as the cause of pharyngitis. J Clin Microbiol 1985;22:858–60.PubMedGoogle Scholar
  39. 39.
    Reed BD, Huck W, Lutz LJ, Zazove P. Prevalence of Chlamydia trachomatis and Mycoplasma pneumoniae in children with and without pharyngitis. J Fam Pract 1988;26:387–92.PubMedGoogle Scholar
  40. 40.
    Terezhalmy GT. Oral manifestations of sexually related diseases. Ear Nose Throat J 1983;62:287–96.PubMedGoogle Scholar
  41. 41.
    Sackel SG, Alpert S, Fiumara NJ, Donner A, Laughlin CA, McCormack WM. Orogenital contact and the isolation of Neisseria gonorrhoeae, Mycoplasma hominis, and Ureaplasma urealyticum from the pharynx. Sex Transm Dis 1979;6:64–68.PubMedCrossRefGoogle Scholar
  42. 42.
    Moffet HL, Siegel AC, Doyle HK. Nonstreptococcal pharyngitis. J Pediatr 1968;73:50–60.Google Scholar
  43. 43.
    Huck W, Reed BD, French T, Mitchell RS. Comparison of the directigen 1–2–3 group A strep test with culture for detection of group A beta-hemolytic streptococci. J Clin Microbiol 1989;27: 1715–18.PubMedGoogle Scholar
  44. 44.
    Wegner DL, Witte DL, Schrantz RD. Insensitivity of rapid antigen detection methods and single blood agar plate culture for diagnosing streptococcal pharyngitis. JAMA 1992;267:695–7.PubMedCrossRefGoogle Scholar
  45. 45.
    Pichichero ME, Disney FA, Talpey WB, et al. Adverse and beneficial effects of immediate treatment of group A beta-hemolytic streptococcal pharyngitis with penicillin. Pediatr Infect Dis J 1987; 6:635–43.PubMedCrossRefGoogle Scholar
  46. 46.
    El-Daher NT, Hijazi SS, Rawashdeh NM, al-Khalil IA, Abu-Ekta-ish FM, Abdel-Latif DI. Immediate vs. delayed treatment of group A beta-hemolytic streptococcal pharyngitis with penicillin V. Pediatr Infect Dis J 1991;10:126–30.PubMedCrossRefGoogle Scholar
  47. 47.
    Gerber MA, Randolph MF, DeMeo KK, Kaplan EL. Lack of impact of early antibiotic therapy for streptococcal pharyngitis on recurrence rates. J Pediatr 1990;117:853–8.PubMedCrossRefGoogle Scholar
  48. 48.
    Idsoe O, Guthe T, Willcox RR, de Weck AL. Nature and extent of penicillin side-reactions with particular reference to fatalities from anaphylactic shock. Bull World Health Organ 1968;38: 159–88.PubMedGoogle Scholar
  49. 49.
    Brook I. The role of beta-lactamase-producing bacteria in the persistence of streptococcal tonsillar infection. Rev Infect Dis 1984;6:601–7.PubMedCrossRefGoogle Scholar
  50. 50.
    Seppala H, Nissinen A, Jarvinen H, et al. Resistance to erythromycin in group A streptococci. N Engl J Med 1992;326:292–7.PubMedCrossRefGoogle Scholar
  51. 51.
    Charney E, Bynum R, Eldrege D, et al. How well do patients take oral penicillin? A collaborative study in private practice. Pediatrics 1967;40:188–95.PubMedGoogle Scholar
  52. 52.
    Pichichero ME, Margolis PA. A comparison of cephalosporins and penicillins in the treatment of group A beta-hemolytic streptococcal pharyngitis: a meta-analysis supporting the concept of microbial copathogenicity. Pediatr Infect Dis J 1991;10:275–81.PubMedCrossRefGoogle Scholar
  53. 53.
    Hooton TM. A comparison of azithromycin and penicillin V for the treatment of streptococcal pharyngitis. Am J Med 1991;91:23S–26S.CrossRefGoogle Scholar
  54. 54.
    Stein GE, Christensen S, Mummaw N. Comparative study of clarithromycin and penicillin V in the treatment of streptococcal pharyngitis. Eur J Clin Microbiol Infect Dis 1991;10:949–53.PubMedCrossRefGoogle Scholar
  55. 55.
    Sexually transmitted diseases treatment guidelines. MMWR 1989;38:1–43.Google Scholar
  56. 56.
    Tompkins RK, Burnes DC, Cable WE. An analysis of the cost-effectiveness of pharyngitis management and acute rheumatic fever prevention. Ann Intern Med 1977;86:481–92.PubMedCrossRefGoogle Scholar
  57. 57.
    Quinn RW, Denny FW, Riley HD. Natural occurrence of hemolytic streptococci in normal school children. Am J Public Health 1956;47:995–1007.Google Scholar
  58. 58.
    Hoffmann S. The throat carrier rate of group A and other beta-hemolytic streptococcal among patients in general practice. Acta Pathol Microbiol Immunol Scand 1985;93:347–51.Google Scholar
  59. 59.
    Brook I, Leyva F. The treatment of the carrier state of group A beta-hemolytic streptococci with clindamycin. Chemotherapy 1988;27:360–7.CrossRefGoogle Scholar
  60. 60.
    Gray GC, Escamilla J, Hyams KC, Struewing JP, Kaplan El, Tupponce AK. Hyperendemic Streptococcus pyrogenes infection despite prophylaxis with penicillin G enzathine. N Engl J Med 1991;325:92–7.PubMedCrossRefGoogle Scholar
  61. 61.
    Denny FW. The streptococcus saga continues [editorial;comment]. N Engl J Med 1991;325:127–8.PubMedCrossRefGoogle Scholar

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© Springer Science+Business Media New York 1994

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  • Barbara D. Reed

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