Bacteriologic features of chronic sinusitis in children.

Aspiration of chronically inflamed sinuses was aseptically performed in 40 children. The median age was 11 years (range, 6 to 16 years). The sinuses were the maxillary (15 cases), ethmoid (13), and frontal (seven). Pansinusitis was present in five patients. All aspirates were cultured for aerobes and anaerobes and yielded bacterial growth in 37 patients. A total of 121 isolates (97 anaerobic and 24 aerobic) were recovered, accounting for 2.7 anaerobes and 0.6 aerobes per specimen. Anaerobic organisms were recovered from all 37 culture-positive specimens, and in 14 cases (38%) they were mixed with aerobic organisms. The predominant anaerobic organisms were Bacteroides species (36), anaerobic Gram-positive cocci (28), and Fusobacterium species (13). The predominant aerobic isolates were alpha-hemolytic streptococci (seven), Staphylococcus aureus (seven), and Haemophilus species (four). These findings indicate the major role of anaerobic organisms in the polymicrobial cause of long-term sinusitis in children.