[Staphylococcus, the most frequent agent of serious complications of acute sinusitis in children. 5 cases].

The high incidence of staphylococcal infection in severe forms of orbital cellulitis is reviewed with 4 case reports of children with complications of acute sinusitis due to staphylococcal infection. Three cases of thrombosis of the sinus cavernosus due to ethmoidal extension were observed, complicated in one case by fatal purulent meningitis. In one case, the sinusitis was a mixed staphylococcal and anerobic infection with orbital cellulitis and subcutaneous gas gangrene. No organism was isolated in the fifth child who had exophtalmos due to retroorbital cellulitis, but a rapid recovery was obtained with anti staphylococcal antibiotics after failure of inappropriate antibiotics. In conclusion, all periorbital cellulitis complicating sinusitis should be prescribed active anti staphylococcal antibiotics. In addition low dose anti coagulant therapy and prophylactic treatment against cerebral aedema are recommanded because of the risk of extension of the infection by thrombophlebitis of the sinus cavernosus and of intracranial propagation of the periorbital aedema.