How are sinus infections treated?

[GraceUnderPressure]

Ok, so we need to rule out whatever possible sources of infection that we can before we try IVIG - sinus infection is definitely possible in ds18's case.

 

So how do we go about determining if there is one & how are they usually treated?

[DebC]

Ok, so we need to rule out whatever possible sources of infection that we can before we try IVIG - sinus infection is definitely possible in ds18's case.

 

So how do we go about determining if there is one & how are they usually treated?

 

Our non PANDAS child has chronic sinus issues. They can check for sinus infections using a traditional sinus x-ray. If that shows nothing and infection of the sinuses is still suspected, a sinus CT scan can be done. These are usually more thorough than a traditional x-ray. Treatment should be an antibiotic for at least 20 days. Per our ENT a traditional 7 to 10 day course will not cure the infection as there is so little blood flow to the area. We've done an antibiotic for 20 days or Azithromycin (5 days on, 3 days off, 5 days on). In fact, our son is half way through a 20 day round of Cefdinir for a current infection.

Edited November 23, 2010 by DebC

[kimballot]

Hi Grace -

This was the topic of a lengthy discussion over the summer, and I learned alot. Here is the thread

http://www.latitudes.org/forums/index.php?showtopic=9549&st=0&p=80199&hl=+chronic%20+sinusitis&fromsearch=1entry80199

 

Let me know if there is anything I can help you with.

[mk8898]

Kimballot - thanks for posting the thread. It brought up several questions. Did you do a steriod burst b/c of the sinus infection or b/c of PANDAS? Our 11 yo son was diagnosed in May of 09. We started augmentin and 30 day steriod burst and t&A surgery. He would get strep twice a year which started out as a sinus infection. We see a allergy/immunologist dr. We do daily nose sprays and nasal rinse of needed. He has not had any major sinus issues until the past month or so. We just switched from augmentin to omnicef (only for 10 days). Im wondering if we need to go longer then 10 days on the omnicef before we go back to augmentin?? Is it the steriod that kept him from having any sinus issues??? I awaiting a call in for a short steriod burst from Dr. L. We have seen some PANDA sysmptoms that we haven't seen for a while.

[kimballot]

MK -

Hmmm... I am not sure if I am reading this correctly. He did a 30 day steroid burst in May of 09 along with a t&A? He then stayed on augmentin but started with sinus symptoms in the last month and now you've done 10 days of ominicef and PANDAS stuff is coming back. Is that correct?

 

If his strep throat always started with sinusitis, I am wondering if he is truly harboring strep in his sinuses. Perhaps the augmentin kept it under wraps for the most part, but he may have been exposed to something else or had allergies start sinus symptoms. I don't think omnicef is as good as augmentin at strep (I may be wrong on that), though omnicef is good for other types of sinus infections. It is so hard to know.

 

Also - is he on an antifungal? I had posted information on fungal sinusitis in that thread. I know they cultured fungus in my son's sinuses with his first two sinus surgeries (before we started using diflucan).

 

Regarding the steroid burst... we've done steroid bursts for sinusitis alone in the past when we had a really stubborn one that would not clear. I believe the thinking was that it would stop inflammation and allergic reaction so that everything could drain out and the antibiotics could work. Usually just a 5-day course.

 

Last April the ENT ordered a 5 day course for the sinus infection. We saw Dr. B for the first time a couple of days after the course ended, and he ordered 17 more days for the PANDAS symptoms. It definitely calmed down the PANDAS and the sinusitis, but it all came back once the steroids ended because he had that infected cyst that we did not know about at the time.

Edited November 24, 2010 by kimballot