The role of Chlamydia pneumoniae infection in children with chronic sinusitis

Abstract

Background: Chlamydia pneumoniae infection is a frequent cause of lower respiratory disease in both adults and children. However, its role in upper respiratory disease, including sinusitis, is less clear. Objective: To determine the role of infection with C pneumoniae in chronic sinusitis in children. Design: Prospective collection of specimens. Setting: Tertiary care academic medical center. Participants: Children with clinical and radiologic evidence of chronic sinusitis unresponsive to medical management undergoing adenoidectomy, maxillary sinus lavage, or endoscopic sinus surgery for treatment. Intervention: Nasopharyngeal and middle meatal swabs and portions of surgical specimens were obtained and cultured for C pneumoniae. Results: Specimens were obtained from 20 children (14 boys and 6 girls) aged 3 through 16 years. Thirteen bilateral endoscopic ethmoidectomies with maxillary antrostomies, 10 adenoidectomies, and 3 bilateral maxillary sinus lavages were performed. Chlamydia pneumoniae was isolated from the nasopharyngeal swab and adenoid tissue of 1 child (aged 6 years); however, his middle meatal swabs and maxillary sinus aspirates were negative. After 10 days of treatment with clarithromycin, repeat nasopharyngeal cultures were negative for C pneumoniae. Conclusions: With the use of sensitive culture methods, C pneumoniae was not isolated from sinus specimens of children enrolled in this study. This preliminary study suggests that C pneumoniae does not play a significant role in chronic sinusitis in children.