Sinus Infections Can Cause Toxic Shock Syndrome In Children

By Margarita Nahapetyan

Sinus infections can put kids at an increased risk of developing toxic shock syndrome, report the scientists from the United States, who state that sinus infections might be responsible for more than 20 per cent of all cases of toxic shock syndrome in children.

Toxic shock syndrome, a potentially fatal condition caused by bacterial toxins, is often linked to tampon use (nearly half of all cases), surgical wound and postpartum infections. The condition is characterized by fever, rash, malaise, confusion, vomiting, diarrhea and strong muscle pain. Blood pressure drops to dramatically low levels, which results in multiple organ failure and even death in some individual cases. Many types of connective tissue lesions are also considered as risk factors that contribute to the condition.

The link between sinus infection and toxic shock syndrome in children has been largely overlooked until this time, said a principal investigator of the study, Dr. Kenny Chan, MD, chief of pediatric otolaryngology at The Children's Hospital and professor of otolaryngology at the University of Colorado, Denver. Dr. Chan said that physicians who treat kids with toxic shock syndrome should know about the risk factors. "Prompt imaging studies of the sinuses is mandatory when no apparent cause of toxic shock syndrome is found," Dr. Chan said.

In the new study, the expert and his team looked at the medical records of 76 children with an average age of 10 years, who were diagnosed with toxic shock syndrome between 1983 and 2000. Of all the children, 23 were diagnosed with acute or chronic sinus rhinosinusitis. Ten of the 23 children with toxic shock syndrome and rhinosinusitis were admitted to the intensive care unit, 4 of them required medications in order to increase blood pressure, and 6 had surgery, the researchers said. According to the study's authors,

rhinosinusitis was found to be the primary cause of toxic shock syndrome 21 per cent of the time in this series.

Rhinosinusitis is inflammation in the sinus passages that are surrounding the nose, which is often triggered by some sort of infection as a result of bacteria, viral, allergic or autoimmune issues. General symptoms of the condition include facial pain, ear pressure, blockage in the nasal passages, fatigue, fever, headaches and even halitosis (bad breath). Medical experts say that once rhinosinusitis is diagnosed, patients should see an otolaringologist (ear, nose and throat specialist), and, if warranted, the doctor should consider sinus culture as well as lavage.

The number of reported toxic shock syndrome incidence following the nasal surgery is 16 cases out of 100,000 patients. There have been 5 unusual cases of delayed condition reported that happened after functional endonasal sinus surgery during which no packing was used. The condition developed in three children and two adults in the period between five days and five weeks after the operation. All of the patients were successfully treated without further complications.

The findings are published In the June issue of Archives of Otolaryngology - Head & Neck Surgery journal.