Sinusitis in Children
Recognizing the Signs and Seeking the Right Care
What is Sinusitis?
Sinusitis occurs when the sinuses become blocked and filled with fluid, creating an environment where bacteria can grow and cause an infection. The condition may be a result from a range of causes that include the common cold, allergic rhinitis, nasal polyps, or a deviated septum.
Viral Upper Respiratory Tract Infection vs. Bacterial Sinusitis
A viral upper respiratory tract infection, commonly known as the common cold, is caused by a virus and is often self-limiting. Symptoms include a runny nose, sneezing, mild fever, and a feeling of being unwell. These infections typically last from 6-9 days.
On the other hand, bacterial sinusitis is an infection of the sinuses by bacteria. It can arise as a secondary infection after a viral infection. According to the national guidelines by the American Academy of Pediatrics (AAP), symptoms of bacterial sinusitis in children include:
Cold symptoms lasting more than ten days without improvement.
A high fever with a nasal discharge following a cold.
Worsening symptoms after a cold seemed to be getting better.
The Frequency of Viral Infections in Children
Children, especially those in daycare or school settings, can have multiple viral upper respiratory tract infections each year, sometimes as many as 6 to 8 per year for younger kids. The majority of these infections are caused by viruses and will resolve on their own without the need for antibiotics.
However, research suggests that approximately 5-10% of viral upper respiratory infections can lead to bacterial sinusitis. It's crucial for parents and caregivers to be vigilant and observe if the child's symptoms linger or worsen.
When are Antibiotics Indicated?
Antibiotics are prescribed when a bacterial infection is suspected. According to the AAP's guidelines, antibiotics may be considered for children with severe onset of symptoms such as fever and nasal discharge lasting for at least three consecutive days. They may also be recommended if symptoms like nasal discharge and cough or fever persist for ten days without any signs of improvement.
However, it's essential to note that unnecessary use of antibiotics when not needed can lead to antibiotic resistance. This makes bacteria stronger and harder to kill, which can result in longer-lasting illnesses, more doctor visits, and the use of stronger antibiotics.
When to Visit a Pediatric ENT?
While your primary care pediatrician can diagnose and treat many cases of sinusitis, there are situations where the expertise of a pediatric Ear, Nose, and Throat (ENT) specialist might be beneficial:
Chronic Sinusitis: If your child experiences multiple episodes of acute sinusitis or has symptoms lasting more than 12 weeks, they might be suffering from chronic sinusitis.
Recurrent Sinusitis: If your child experiences sinusitis multiple times a year, even if each episode is treated successfully.
Complications: Rarely, sinusitis can lead to complications, such as infections that spread to nearby areas. If you notice severe symptoms or any eye swelling, it's essential to seek specialized care.
Nasal Polyps or Structural Abnormalities: Some children might have nasal polyps or structural issues, like a deviated septum, contributing to recurrent or chronic sinusitis. An ENT can assess and treat these conditions.
In conclusion, while sinusitis is common in children, understanding the differences between a viral infection and bacterial sinusitis is critical. Recognizing the signs and seeking appropriate care, whether from a pediatrician or an ENT specialist, ensures your child gets the best treatment and recovers quickly. Always remember that antibiotics should be used judiciously and only when indicated. A collaborative approach between caregivers, pediatricians, and specialists will ensure that children with sinusitis get the best care possible.