Subclinical chronic sinusitis causing ventriculoperitoneal shunt sepsis

Subclinical chronic sinusitis causing presumed ventriculoperitoneal shunt sepsis in a child


1Department of Otorhinolaryngology, College of Medicine, University of Ibadan and Department of Otorhinolaryngology, University College Hospital, Ibadan, Nigeria

2 Division of Neurological Surgery, Department of Surgery, College of Medicine, University of Ibadan, and Department of Neurological Surgery, University College Hospital, Ibadan, Nigeria

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Rhinosinusitis is often under diagnosed and overlooked in children. Fever as the only symptom of rhinosinusitis is rare and largely unreported. A three-year-old boy with a right frontal ventriculo-peritoneal (VP) shunt for congenital hydrocephalus presented with a three-month history of recurrent high grade intermittent fever. He had no other symptoms. A cranial Computed Tomogram for VP shunt evaluation revealed isodense lesions filling the right and left ethmoidal and maxillary sinuses. Bilateral inferior meatal puncture revealed frank pus in both maxillary sinuses. Microbacterial culture yielded Streptococcus pyogenes sensitive to Erythromycin. Following treatment, fever subsided and remained so in subsequent outpatients’ visits.

Keywords:   Fever; Subclinical chronic sinusitis; Ventriculo-peritoneal shunt

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How to cite this article:
A. DANIEL and A.O. ADELEYE. Subclinical chronic sinusitis causing presumed ventriculoperitoneal shunt sepsis in a child. International Journal of Case Reports, 2017 1:2. DOI: 10.28933/ijcr-2017-03-1101


1. A.M. Fendrick, S. Saint, I. Brook, Jacobs M.R. Jacobs, S. Pelton, S. Sethi, Diagnosis and treatment of upper respiratory tract infections in the primary care setting. Clin Ther. 23 (2001) 1683-1706.
2. E.R. Wald, N. Guerra, C. Byers, Upper respiratory tract infections in young children: duration of and frequency of complications. Paediatr. 87 (1991)129-133.
3. R. Lusk, Paediatric chronic rhinosinusitis, Curr Opin in Otolaryngol. Head Neck Surg. 14 (2006) 393-396.
4. M. W. Criddle, A. Stinson, M. Savliwala, and J. Coticchia, Pediatric chronic rhinosinusitis: a retrospective review, Am J. Otolaryngol. 29 (2008) 372-378.
5. E. R. Wald, K. E. Applegate, C. Bordley, D.H. Darrow, M. P. Glode, S. M. Marcy, C.E. Nelson, R.M. Rosenfold, N. Shaikh, M.J. Smith, P.V. Williams; American Academy of Paediatrics, Clinical Practice Guideline for the Diagnosis and Management of Acute Bacterial Sinusitis in Children Aged 1 to 18 Years. Paediatr. 132 (2013) 262-280.
6. J. A. Stankiewicz and J. M. Chow, A diagnostic dilemma for chronic rhinosinusitis: definition accuracy and validity, Am J. Rhinol. 16 (2002) 199-202.
7. C. L. Slack, K. A. Dahn, M. J. Abzug, and K. H. Chan, Antibiotic-resistant bacteria in paediatric chronic sinusitis, Paediatr. Infect. Dis. J. 20 (2001) 247–250.
8. B. A. Senior, D. W. Kennedy, J. Tanabodee, H. Kroger, M. Hassab, D. Lanza, Long-term results of functional endoscopic sinus surgery, Laryngoscope, 108 (1998) 151-157.
9. M. R. Bothwell, J. F. Piccirillo, R. P. Lusk, B. D. Ridenour, Long-term outcome of facial growth after functional endoscopic sinus surgery, Otolaryngol. Head Neck Surg. 126 (2002) 628-634.
10. S. J. Vandenberg, D. G. Heatley, Efficacy of adenoidectomy in relieving symptoms of chronic sinusitis in children, Arch. Otolaryngol. Head Neck Surg. 123 (1997) 675-678.
11. H. H. Ramadan, Adenoidectomy vs endoscopic sinus surgery for the treatment of paediatric sinusitis, Arch. Otolaryngol. Head Neck Surg. 125 (1999) 1208-1211.
12. R. L. Hebert II, J. P. Bent III, Meta-analysis of outcomes of Paediatric Functional Endoscopic sinus surgery, Laryngoscope, 108 (1998) 796-799.
13. H. H. Ramadan, J. L. Cost, Outcome of adenoidectomy versus adenoidectomy with maxillary sinus wash for chronic rhinosinusitis in children, Laryngoscope, 118 (2008) 871–873.
14. J. B. Anon, Acute bacterial rhinosinusitis in paediatric medicine: current issues in diagnosis and management, Paediatr. Drugs, 5 (2003) 25–33.

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