The role of microbes in the pathogenesis of acute rhinosinusitis in young adults. (5th August 2014)

• Record Type: Journal Article
• Authors: Autio, Timo J.; Tapiainen, Terhi; Koskenkorva, Timo; Närkiö, Mervi; Lappalainen, Maija; Nikkari, Simo; Hemmilä, Heidi; Koskela, Katja A.; Koskela, Markku; Koivunen, Petri; Alho, Olli‐Pekka
• Is Part Of: Laryngoscope. Volume 125:Number 1(2015:Jan.)
• Page Start: E1
• Page End: E7
• Publication Date: 2014-08-05
• Subjects: Otolaryngology -- Periodicals; 617.51005
• DOI: 10.1002/lary.24862
• Languages: English
• ISSNs: 0023-852X

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="lary24862-sec-0001" sec-type="section"> <title>Objectives/Hypothesis</title> <p>To provide information on the course of acute rhinosinusitis (ARS) with sequential nasal and paranasal microbiological data and their correlation with clinical outcomes.</p> </sec> <sec id="lary24862-sec-0002" sec-type="section"> <title>Study Design</title> <p>We conducted a prospective cohort study among 50 Finnish military recruits with clinically diagnosed ARS in spring 2012.</p> </sec> <sec id="lary24862-sec-0003" sec-type="section"> <title>Methods</title> <p>We collected symptom, nasal endoscopy, and cone‐beam CT (CBCT) scores during the early (2–3 days from onset) and later phases (9–10 days). We took viral samples from the nasopharynx (multiplex respiratory virus polymerase chain reaction [PCR]), bacterial culture from the middle meatus during both phases, and both viral and bacterial samples from the maxillary sinus aspirate (respiratory virus PCR, bacterial culture, broad‐range bacterial PCR) during the later phase. Cilia destruction and microbial biofilms were sought from a nasal mucosal biopsy sample.</p> </sec> <sec id="lary24862-sec-0004" sec-type="section"> <title>Results</title> <p>We found that 42 (84%) of the subjects had viral nucleic acid in the nasopharynx during ARS. During the early phase, 28 (56%) of the subjects had nontypeable <italic>H. influenzae</italic> (NTHi) in the middle meatus, which was associated with wider paranasal mucosal changes in CBCT scans and increased symptoms during the study period. After 9 to 10 days from the onset, NTHi was found in the maxillary sinus in eight subjects (40%, 8/20) and led to prolonged symptoms. Bacterial biofilm was ruled out in 39 (78%) cases, and cilia destruction did not correlate with microbiological or clinical outcomes.</p> </sec> <sec id="lary24862-sec-0005" sec-type="section"> <title>Conclusion</title> <p>Nasal and paranasal <italic>H. influenzae</italic> coinfection during viral infection may modify the symptoms and the extent of sinonasal mucosal disease observed in CBCT scans already from the beginning of the ARS episode.</p> </sec> <sec id="lary24862-sec-0006" sec-type="section"> <title>Level of Evidence</title> <p>N/A. <italic>Laryngoscope</italic>, 125:E1–E7, 2015</p> </sec> </abstract>