Haemophilus influenzae infections sinusitis

Infections of the external eye can be caused by viruses and by bacteria from the respiratory tract such as pneumococci and Haemophilus influenzae. Infections of the internal eye can be caused by the same bacteria through spread from a corneal (traumatic) ulcer or by S. aureus. The same pathogens are responsible for periorbital spread in severe sinusitis. Treponema pallidum, CMV and Toxoplasma cause intra-ocular infections. 

Although viral infections are important causes of both otitis media and sinusitis, they are generally self-limiting. Bacterial infections m complicate viral illnesses, and are also primary causes of ear and sinus infections. Streptococcus pneumoniae and Haemophilus influenzae are the commonest bacterial pathogens. Amoxycillin is widely prescribed for these infections since it is microbiologically active, penetrates the middle ear, and sinuses, is well tolerated and has proved effective. 

A 2.5-year-old female with a sinus infection caused by Haemophilus influenzae is treated with trimethoprim-sulfamethoxazole. 

Levofloxacin (1), the levo-isomer or the (5)-enantiomer of ofloxacin, received FDA approval in 1996 (Fish, 2003 Hurst et al., 2002 Mascaretti, 2003 Norrby, 1999 North et al., 1998). The initial approval covered community-acquired pneumonia, acute bacterial exacerbation of chronic bronchitis, acute maxillary sinusitis, uncomplicated skin and skin structure infections, acute pyelonephritis, and complicated urinary tract infections (North et al., 1998). Four years later, the levofloxacin indication list grew to include community-acquired pneumonia caused by penicillin-resistant Streptococcus pneumoniae. In addition, in 2002, nosocomial (hospital-acquired) pneumonia caused by methicillin-susceptible Staphylococcus aureus, Pseudomonas aeruginosa, Serratia marcescens, Haemophilus influenzae, Kliebsella pneumoniae, and Escherichia coli was added (Hurst et al., 2002). Finally in 2004, LVX was approved as a post-exposure treatment for individuals exposed to Bacillus anthracis, the microbe that causes anthrax, via inhalation (FDA, 2004). 

Haemophilus influenzae Upper respiratory tract infections, otitis media, sinusitis, pneumonia, meningitis Conjunctivitis, dacryocystitis, preseptal and orbital cellulitis, endophthalmitis... 

Mild cases, characterised by pinkness or infection of the eardrum, often resolve spontaneously and need only analgesia emd observation. They are normally viral. A bulging, inflamed eardrum indicates bacterial otitis media usually due to Streptococcus pneumoniae, Haemophilus influenzae, Moraxella (Bran-hamella) catarrhalis. Streptococcus pyogenes (Group A) or Staphylococcus aureus. Amoxicillin or co-amoxiclav is satisfactory, but the clinical benefit of antibiotic therapy is very small when tested in controlled trials. Chemotherapy has not removed the need for myringotomy when pain is very severe, and also for later cases, as sterilised pus may not be completely absorbed and may leave adhesions that impair hearing. Chronic infection presents a similar problem to that of chronic sinus infection, above. 

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