Medical Paper Papers
1: Curr Infect Dis Rep. 2001 Jun;3(3):209-216.
The Microbiology and Management of Acute and Chronic Rhinosinusitis.
Hadley JA.
Genesee Valley Otolaryngology, LLC, 1065 Senator Keating Boulevard, Suite 210, Rochester,
NY 14618, USA. enthadley@aol.com
Although most cases of rhinosinusitis are benign, the disruption of quality of life
due to disease symptoms leads patients to seek early medical care. Ongoing debates
dispute the definition, bacteriology, and medical management of chronic sinusitis,
while the criteria for acute sinusitis are relatively well established. Chronic
rhinosinusitis remains poorly categorized, and authors differ in opinions of symptoms,
time course, and bacteriology of the infections, as well as proper medical management.
Recent studies from the Mayo Clinic even question the idea that chronic sinusitis
is a bacterial disease and document the presence of fungal pathogens that are responsible
for the inflammatory reaction and mucosal response. In general, medical management
is based on physiologic principles of re-establishing natural mucociliary function
and restoring proper aeration of the paranasal sinuses after an inflammatory insult.
Injudicious use and indiscriminate overprescription of antibiotics has fostered
the rapid development of penicillin-resistant organisms over the past two decades.
Drug-resistant Streptococcus pneumonia and b-lactamase-producing Haemophilus influenzae
and Moraxella catarrhalis are becoming the norm, forcing the need to consider alternatives
in antibacterial management. Appropriate medical management of this common problem
requires a systematic approach and consideration of adjunctive therapy. This article
examines the current bacteriology of these common infections and reviews the management
of acute and chronic infections.
PMID: 11384550 [PubMed - as supplied by publisher]
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