Most preschool children hospitalised for acute rhinosinusitis had orbital complications, more common in the youngest and among boys

• Published in: Acta Paediatrica Vol. 106; no. 2; pp. 268 - 273
• Main Authors: Schollin Ask, L, Hultman Dennison, S, Stjärne, P, Granath, A, Srivastava, S, Eriksson, M, Lindstrand, A, Ryd Rinder, M
• Format: Journal Article
• Language: English
• Published: Norway Wiley Subscription Services, Inc 01.02.2017
• Subjects: Anti-Bacterial Agents - administration & dosage; Bacteria; Cellulitis; Child, Preschool; Children; Children & youth; Complications; Female; Health risk assessment; Hospitalisation; Hospitalization; Humans; Incidence; Infant; Male; Medicin och hälsovetenskap; Orbital complications; Orbital Diseases - drug therapy; Orbital Diseases - epidemiology; Orbital Diseases - etiology; Orbital Diseases - microbiology; Population studies; Preschool children; Preseptal cellulitis; Retrospective Studies; Rhinitis; Rhinitis - complications; Rhinitis - diagnostic imaging; Rhinitis - drug therapy; Rhinitis - microbiology; Rhinosinusitis; Sinusitis; Sinusitis - complications; Sinusitis - diagnostic imaging; Sinusitis - drug therapy; Sinusitis - microbiology; Streptococcus infections; Streptococcus pneumoniae; Sweden - epidemiology; Tomography, X-Ray Computed; Preseptal cellulitis; Preschool children; Sinusitis; Orbital complications; Hospitalisation
• ISSN: 0803-5253; 1651-2227; 1651-2227
• DOI: 10.1111/apa.13650

Aim This study established the incidence of acute rhinosinusitis and related orbital complications in tertiary care in Stockholm County and surveyed the clinical outcomes. Methods This was a population‐based, retrospective, observational study, from July 1, 2003 to June 30, 2007, of the hospital admissions records of 213 children up to five years old, with a diagnosis of sinusitis and related complications. Results Preseptal cellulitis was present in 171 of the 213 admissions, which equated to an incidence of orbital complications due to acute rhinosinusitis of 36 per 100 000 people per year (95% confidence interval 26–49). Postseptal complications occurred in seven cases. The incidence rate ratio for hospitalisation of children less than two years old with rhinosinusitis compared with children aged 2–5 years was 2.8 (95% confidence interval 1.8–4.4). The incidence among boys was 53 per 100 000 people per year and 36 per 100 000 people per year for girls, and the incidence rate ratio was 1.5 (95% confidence interval 1.0–2.3). The most common bacterial finding was Streptococcus pneumoniae. Conclusion Most children hospitalised for acute rhinosinusitis had an orbital complication, and this was more common in children under the age of two years and boys. Severe postseptal complications were rare.