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Respiratory Disorders (Expert Forum)
3 1/2 year old with chronic sinusitis, please advise
Answered by
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3 1/2 year old with chronic sinusitis, please advise
by JenT, May 25, 2002 12:00AM
Daughter has had chronic sinus infections for over a year. She has been on numerous antibiotics, but none keep her well for more than a week off them. She's had an mri and ct scan, her anatomy is fine and there are no blockages.She's had her adenoids (adenoids) removed. Cultured bacteria is 3 most common usually found.
She does have mild allergies (skin test) to dogs, cats (have both in the home),some environmental, incl. a moderate allergy to Candida. ENT doesn't think it's allergies because she doesn't have a long clear period, but I wonder if she is constantly exposed, maybe she doesn't get a chance to get better?Or maybe the rise of Candida in her sinuses due to long term antibiotics is causing an allergic reaction which provides a breeding ground for bacteria?
He doesn't think it could be fungal because it isn't brown (it's thick green), is that your opinion as well?
Most recently, she was on Cefzil for 5 weeks of a 6 week course and the infection returned while on antibiotics, and didn't respond to a 5 day course of prednisone.
ENT thinks maybe Iga deficiency, will be tested Wed, but she is healthy, except for the pus coming out of her nose. She never gets sick. She has only had one ear infetion in her life at 2yr.
The pus comes straight out of her nose, doesn't run down her throat or into her ears. She doesn't have fever or pain.
If you could, please give me some thoughts and ideas that I could approach the ENT with. We are working with this ENT, her allergist and pediatrician. Do you know of a diff. specialist that might be able to look at this with new eyes
She does have mild allergies (skin test) to dogs, cats (have both in the home),some environmental, incl. a moderate allergy to Candida. ENT doesn't think it's allergies because she doesn't have a long clear period, but I wonder if she is constantly exposed, maybe she doesn't get a chance to get better?Or maybe the rise of Candida in her sinuses due to long term antibiotics is causing an allergic reaction which provides a breeding ground for bacteria?
He doesn't think it could be fungal because it isn't brown (it's thick green), is that your opinion as well?
Most recently, she was on Cefzil for 5 weeks of a 6 week course and the infection returned while on antibiotics, and didn't respond to a 5 day course of prednisone.
ENT thinks maybe Iga deficiency, will be tested Wed, but she is healthy, except for the pus coming out of her nose. She never gets sick. She has only had one ear infetion in her life at 2yr.
The pus comes straight out of her nose, doesn't run down her throat or into her ears. She doesn't have fever or pain.
If you could, please give me some thoughts and ideas that I could approach the ENT with. We are working with this ENT, her allergist and pediatrician. Do you know of a diff. specialist that might be able to look at this with new eyes
Doctor's Answer
by National Jewish, Jun 26, 2002 12:00AM
, Jun 26, 2002 12:00AM
This is obviously a very complicated case. With a normal MRI and CT of the sinuses, looking at zebras becomes more the rule than the exception.
1. It is possible to have a chronic fungal infection of the sinuses after lots of antibiotics and possibly steroids.
2. In allergic individuals, a positive test to Candida does not mean a lot.
3. If she is allergic to dust mite and pets, I would recommend doing all you can to reduce her exposure to these things in the bedroom. Covering the mattress, pillow, getting rid of stuffed animals etc is safe and may show some results.
4. An immunoglobulin A (IgA) deficiency is possible, as well as a selective Immunoglobulin G (IgG) deficiency.
These are just possibilities to evaluate. Another option is being see here at National Jewish if the problem persists for a new "set of eyes".
1. It is possible to have a chronic fungal infection of the sinuses after lots of antibiotics and possibly steroids.
2. In allergic individuals, a positive test to Candida does not mean a lot.
3. If she is allergic to dust mite and pets, I would recommend doing all you can to reduce her exposure to these things in the bedroom. Covering the mattress, pillow, getting rid of stuffed animals etc is safe and may show some results.
4. An immunoglobulin A (IgA) deficiency is possible, as well as a selective Immunoglobulin G (IgG) deficiency.
These are just possibilities to evaluate. Another option is being see here at National Jewish if the problem persists for a new "set of eyes".
