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Anthony L. Picone
Clinton E. Baisden
Mark E. Sand
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Ann Thorac Surg 1993;55:706-710
© 1993 The Society of Thoracic Surgeons

Articles

Paranasal sinusitis: Cryptic sepsis after coronary artery bypass operations

Anthony L. Picone, MD*, Clinton E. Baisden, MD, Edward G. Ford, MD, Mark E. Sand, MD

Division of Thoracic Surgery, Department of Surgery, Keesler Medical Center (ATC), Keesler Air Force Base, Mississippi, USA

Accepted for publication June 30, 1992.

* Address reprint requests to Dr Picone, SGHS/Keesler Medical Center, Keesler AFB, MS 39534-5300.

Infections occurred in 52 of 400 patients (13%) undergoing coronary artery bypass operations from January 1987 to December 1990. The hospital courses of 5 patients (1.3%) in whom occult infections of the paranasal sinuses developed were reviewed. Only 1 patient had specific clinical findings of acute sinusitis (purulent nasal discharge). Computed tomography showed wall thickening, opacification, or air-fluid levels in one or more paranasal sinuses in each patient. All patients were successfully treated with surgical drainage and antibiotics. Risk factors for development of postoperative acute sinusitis include: prolonged tracheal intubation, airway colonization with nosocomial bacteria, inability to clear nasal secretions, sinus ostial obstruction, and critical organ system dysfunction. Physical examination and roentgenographic evaluation of the paranasal sinuses should be considered when postoperative sepsis of obscure etiology occurs.






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Copyright © 1993 by The Society of Thoracic Surgeons.