Are Nasopharyngeal Cultures Useful in Diagnosis of Acute Bacterial Sinusitis in Children?

The diagnosis of acute bacterial sinusitis can be challenging because symptoms of acute sinusitis and an upper respiratory tract infection (URI) overlap. A rapid test, if accurate in differentiating sinusitis from URI, could be helpful in the diagnostic process. We examined the utility of nasopharyn...

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Bibliographic Details
Published in:Clinical pediatrics 2013-12, Vol.52 (12), p.1118-1121
Main Authors: Shaikh, Nader, Hoberman, Alejandro, Colborn, D. Kathleen, Kearney, Diana H., Jeong, Jong H., Kurs-Lasky, Marcia, Barbadora, Karen A., Bowen, A’Delbert, Flom, Lynda L., Wald, Ellen R.
Format: Article
Language:English
Subjects:
Acute Disease
Antimicrobial agents
Bacteria
Child
Child, Preschool
Children & youth
Culture Techniques
Diagnosis, Differential
Female
Haemophilus Infections - diagnosis
Haemophilus Infections - diagnostic imaging
Haemophilus influenzae - isolation & purification
Humans
Likelihood Functions
Male
Medical diagnosis
Moraxella (Branhamella) catarrhalis - isolation & purification
Moraxellaceae Infections - diagnosis
Moraxellaceae Infections - diagnostic imaging
Nasopharynx - microbiology
Pathogens
Pediatrics
Pneumococcal Infections - diagnosis
Pneumococcal Infections - diagnostic imaging
Predictive Value of Tests
Prospective Studies
Radiography
Respiratory diseases
Sinuses
Sinusitis - diagnosis
Sinusitis - diagnostic imaging
Sinusitis - microbiology
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Summary:The diagnosis of acute bacterial sinusitis can be challenging because symptoms of acute sinusitis and an upper respiratory tract infection (URI) overlap. A rapid test, if accurate in differentiating sinusitis from URI, could be helpful in the diagnostic process. We examined the utility of nasopharyngeal cultures in identifying the subgroup of children with a clinical diagnosis of acute sinusitis who are least likely to benefit from antimicrobial therapy (those with completely normal sinus radiographs). Nasopharyngeal swabs were collected from 204 children meeting a priori clinical criteria for acute sinusitis. All children had sinus X-rays at the time of diagnosis. To determine if negative nasopharyngeal culture results could reliably identify the subgroup of children with normal radiographs, we calculated negative predictive values and negative likelihood ratios. Absence of pathogens in the nasopharynx was not helpful in identifying this low-risk subgroup.
ISSN:0009-9228
1938-2707
DOI:10.1177/0009922813506257