Nosocomlal sinusitis in the surgical intensive care unit (sicu): Are antral taps valuable?

Michael A. Samotowka, Stephen M. Cohn, Kern A. Milner, Ierard A. Bums, Michael E. Ivy, Mark D. Sawyer, Peler A. Angood, Stanley H. Rosenbaum, Melissa Perkai

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Abstract

Introduction Nosocomial Smusius i NS) can he difficult to diagnose, js CT scan is not définitive, and diagnostic maxillary sinus taps iSTl jre invasive jnd require technical expertise We examined our experience with ST to detennine it their results affected clinical management and outcome of NS m the SICH Methods We reviewed patients tpts) admitted to the Yale New Haven Hospital SICU during a 5-year period undergoing diagnostic ST as part of a fever workup for suspected sinusitis Demographic data, culture results and antibiotic usage were noted Results: Forty-five pts underwent a ST (30 male, 15 female) The average age was 46 (17-78) and average SICU length of stay was 30.6 days. 14 (31%) died Thirty-one pts were on the trauma service. 14 had facial fractures and 16 had a closed head iniury Two were nasally mtubated: 37 were orally mtubated (mean davs mtubated =123) Thirty-three pts had a CT showing sinus fluid, suggestive for sinusitis Thirty-tuo ST were positive bv gram slain and culture results. 13 ST ere negative The five most common organisms cultured were staph aureus (10). Candida (10). B-strep (6). staph epidermilis (4), and pseudomonas (4) Of the 32 patients with a positive tap. 26 had concurrent infections, six did not. Twenty-one pis had a change in therapy based upon ST culture results 18 (positive ST) had an addition or change in antibiotic therapy, three (negative ST) had empiric antibiotics discontinued Conclusions 1 ) ST for diagnosis of NS in our ICU was valuable as 21/45 (47%) of pts had a change in therapy 2 ) ST appears warranted for the management of NS in the ICU setting.

Original languageEnglish (US)
Pages (from-to)A131
JournalCritical care medicine
Volume26
Issue number1 SUPPL.
StatePublished - Dec 1 1998

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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