Nelson Textbook of Pediatrics 22nd Edition | Acute bacterial sinusitis: clinical diagnosis (persistent >10 days, double sickening, severe onset). Pathogens: Streptococcus pneumoniae, nontypeable Haemophilus influenzae, Moraxella catarrhalis. Treatment: amoxicillin-clavulanate first-line. Complications: orbital cellulitis, intracranial abscess, Pott puffy tumor. Referral indications: recurrent, severe, immunocompromised.
๐ paeds.online โ Pakistan's Pediatric Platform| Diagnostic Criteria | Clinical Features | Antibiotic Choice |
|---|---|---|
| Persistent (>10 days) | Nasal discharge/cough >10 days without improvement | Amoxicillin-clavulanate 45 mg/kg/day or 90 mg/kg/day for severe |
| Severe onset | Fever โฅ39ยฐC + purulent nasal discharge for 3-4 consecutive days | Amoxicillin-clavulanate 90 mg/kg/day |
| Double sickening (worsening) | Initial improvement then worsening fever/nasal symptoms after day 5-6 | Amoxicillin-clavulanate 90 mg/kg/day |