Complications of Acute Bacterial Rhinosinusitis in Children: A Single Tertiary Care Center

Objective: Acute bacterial rhinosinusitis (ABRS) can lead to serious complications, especially when treated inadequately. In this study, we evaluated pediatric patients treated for sinusitis complications by the Pediatric Infectious Diseases Department at Dokuz Eylul University Fa-culty of Medicine.Material and Methods: Patients who were consulted with a preliminary diagnosis of sinusitis complication and hospitalized between January 2014 and March 2021 were retrospectively analyzed. Patients who de-veloped complications due to causes other than ABRS were excluded. Those with isolated orbital complications and those with intracranial complications were compared.Results: Seventeen patients who were hospitalized for ABRS were inclu-ded in the study. Median age was 13 (min 3-max 17) years, the majority were (14, 82.4%) males. There were isolated orbital complications in 11 (64.7%), intracranial complications in 4 (23.5%), and both orbital and int-racranial complications in two (11.8%) patients. S. pneumoniae, Strepto-coccus spp. and S. constellatus grew in cultures obtained intraoperatively from three patients. Age (median 16 and 12, p= 0.048), number of surge-ries (median 2 and 0, p= 0.027), length of stay (median 44 and 8, p< 0.001), total follow-up time (median 110 and 30, p= 0.015), absolute neutrophil count (median 16700/mm3 and 7000/mm3, p= 0.020) and C-reactive pro-tein (229.0 +/- 62.9 and 65.7 +/- 57.4, p< 0.001) were found to be higher in patients with intracranial complications. Endoscopic sinus surgery was performed in one patient. Three patients were operated by neurosurgery, and one patient by the ophthalmology department. A sequela of drop foot was observed in a patient with subdural empyema and meningitis. Only one patient died after discharge due to her underlying disease.Conclusion: Age, length of hospital stay, and surgical requirement in patients with intracranial complications are higher than those with only orbital complications. There may be sequelae in patients whose surgical needs are not met. However, there are cases in whom only conservati-ve medical therapies were adequate. Randomized studies with larger numbers of patients are needed to obtain definitive data on optimal treatment methods and surgical indications for sinusitis complications in children