Pediatric acute and chronic rhinosinusitis: comparison of clinical characteristics and outcome of treatment

Background: Rhinosinusitis (RS) is a common problem in children. There are very few published studies comparing acute rhinosinusitis (ARS) and chronic rhinosinusitis (CRS) in children. Objective: To determine the clinical manifestations in children with ARS and CRS. Methods: One hundred and fifty-four patients with a clinical diagnosis of RS were enrolled. ARS was defined as persistent symptoms for more than 10 days but less than 4 weeks and CRS was defined as persistent symptoms for longer than 8 weeks. Patients were interviewed to obtain demographic and clinical data. Physical findings and medications were recorded. All patients underwent radiographic studies. Allergy and immunological testing were done in selected case. All data were compared between the ARS and CRS groups. Results: One hundred and three patients were classified as having ARS and fifty-one had CRS. Their mean ( SD) age was 5.9 +/- 3.3 years. Allergic rhinitis was common in the chronic rhinosinusitis group. The most common main complaints in acute and chronic rhinosinusitis were cough and rhinorrhea. There was no significant difference in symptoms between both groups, except for periorbital pain and sleep apnea which were found more frequently in the chronic group. Sixty five percents of ARS and 58.8% of CRS had abnormal x-ray findings. Adenoid hypertrophy was found in the CRS group. There was overall improvement after 14.6 +/- 3.82 days and 22.35 +/- 5.04 days (mean) of antibiotic treatment in the ARS and CRS groups, respectively. None of the patient underwent sinus surgery. Conclusion: The most common RS symptoms were rhinorrhea and cough. Patients with allergic rhinitis had a higher risk of developing chronic rhinosinusitis. Patients with ARS and CRS were successfully treated with medical treatment.