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What are the most likely causative pathogens in adult ABRS (acute bacterial rhino-sinusitis)?
What is S. pneumoniae?
- Most common bacterial pathogen in ABRS, AOM, CAP. Rare (10%) spontaneous resolution in AOM. Treatment target in AOM. It is a gram-positive diplococci.
- =>25% drug-resistant. DRSP risk w/ recent antimicrobial use (within 4-6 weeks), exposure to, or being a child in day care, advancing age.
What is H. influenzae?
- Common pathogen in ABRS, AOM, CAP, particularly in recurrent infection, tobacco users.
- 50% spontaneous resolution in AOM.
- Gram-negative bacillus.
- =>30% penicillin-resistant via beta-lactamase production.
What is M. catarrhalis?
- Less common pathogen in ABRS, AOM, rare cause of CAP.
- About 90% spontaneous resolution in AOM.
- Gram-negative coccus.
- =>90% penicillin-resistant via beta-lactamase production.
What are the diagnostic criteria for adult ABRS?
Nasal drainage, nasal congestion, facial pain/pressure, postnasal drip, hyposmia/anosmia, fever, cough, fatigue, maxillary dental pain, ear fullness.
S/sx of URI => 7-10d or worse after 5-7d.