Sinus gunk again-what to ask DR?

[cobbiemommy]

Ds, 14, has sinus drainage of the nastiest variety, again. He breathing is so noisy and I see him breathing through his mouth a lot. He just finished two weeks of Clindamycin for an impetigo-strep infection. This was his third round of abx for to clear up that particular infection.

 

He has a deviated septum which they don't want to operate on until he is 18. He hasn't been allergy tested for three years and I wonder if he would benefit from new testing and allergy shots. We see both the ENT and the immunologist tomorrow. Any suggestions...

[nicklemama]

Allergy testing showed my son to have allergies. Daily Claritin and Flonase, has helped a lot. No more stuffy nose.

[kimballot]

Cobbie Mommy -

 

I am sorry but I don't recall your son's history. Bear with me if you've already done this.

 

1. Does your son have any immune deficiencies that lead to sinusitis - Low IgA is particularly problematic for sinuses as is low IgG - especially if the s. pneumonae titers are below protective levels. if those have not been checked yet - get them checked.

 

2. If the problem is anatomical (deviated septum), then you want to find out how to keep things flowing and draining while you wait for the sinus surgery. Is there a nasal rinse or netti pot that can be used to keep the mucous from collecting in one spot and becoming a breeding ground for bacteria?

 

3. If he has repeated sinus infections - it can be due to fungal sinusitis and/ or bacterial sinusitis. The doctors may be able to culture the sinuses to determine what is growing in there (though they cannot get back very far)

 

4. Is your son on prophylactic antibiotics? That may be necessary if the septum is not repaired.

 

Best wishes!