New-Onset Bacterial Sinusitis in Pediatric Liver Transplant Recipients; Case Series and Review of Literature

Authors

1 Assistant Prof. of Pediatric Gastroentrohepatology, Pediatric Gastroentrology and Hepatology and Nutrition Research Center, Research Institute for Children Health; Mofid hildren's Hospital, Shahid Beheshti University of Medical Sciences Tehran, Iran.

2 Associate Prof. of Pediatric Gastroentrohepatology, Pediatric Gastroentrology and Hepatology and Nutrition Research Center, Research Institute for Children Health; Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences Tehran, Iran.

3 Neonatal health research center, Research Institute for Children Health, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

4 Prof. of Pediatric Gastroentrohepatology, Department of pediatric Gastroentrology and Hepatology, Nemazee teaching hospital, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

5 Prof. of Pediatric Gastroentrohepatology, Pediatric Gastroentrology and Hepatology and Nutrition Research Center, Research Institute for Children Health; Mofid hildren's Hospital, Shahid Beheshti University of Medical Sciences Tehran, Iran.

6 Department of radiology, Pediatric Gastroentrology, Hepatology and Nutrition Research Center, Research Institute for Children Health, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

7 Department of Radiology, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Abstract

Introduction: As a standard measure in some chronic liver disorder, liver transplantation (LT) has performed for about 3 decades in pediatric populations. Post operatively some patients suffering from infectious complications by viral, bacterial and fungal etiologies. Here in we presented 10 children diagnosed as bacterial sinusitis presenting with prolonged fever and upper respiratory tract symptoms post LT and review the literature.
Case presentation: Ten pediatric LT recipients including 7 boys and 3 girls, aged 1.5 to 8 years (4.7±2.34) with mean weight of 15.6 Kg (range; 11.4–27.5 Kg) were diagnosed as bacterial sinusitis during December 2013 to March 2017. Patients were suffering from respiratory symptoms and prolonged fever. After ruling out other diagnosis and by performing through investigation, we confirmed bacterial sinusitis by sputum culture and result of antibiogram and paranasal Computed Tomography (CT) scan. All patients dramatically responded to intravenous broad-spectrum antibiotic.
Conclusion: In post LT patients who are, suffering from fever or prolonged fever with upper respiratory signs and symptoms, acute sinusitis should kept in mind. Therefore, timely diagnoses coupled with taking therapeutic measures using broad-spectrum antibiotics could prevent disease progression and complications.

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