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Anthony Cultrara, MD; Nira A. Goldstein, MD; Alexander Ovchinsky, MD; Tamara Reznik, BS; Patricia M. Roblin, MS; Margaret R. Hammerschlag, MD

Arch Otolaryngol Head Neck Surg. 2003;129:1094-1097.

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.

From the Departments of Otolaryngology (Drs Cultrara, Goldstein, and Ovchinsky) and Pediatrics–Division of Infectious Diseases (Mss Reznik and Roblin and Dr Hammerschlag), State University of New York Downstate Medical Center, Brooklyn. The authors have no relevant financial interest in this article.

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