Microbiology of sinusitis in patients undergoing bone marrow transplantation

As a result of increasing use of bone marrow transplantation and new cytoto xic chemotherapy, more patients have become susceptible to sinus disease ca used by unusual organisms. Sinusitis caused by fungi and gram-negative bact eria can be difficult to treat, may lead to severe complications, and shoul d be managed promptly in the bone marrow transplant patient. Here we presen t the results of 41 cultures of the paranasal sinuses obtained from 18 bone marrow transplant patients in whom sinusitis developed. The most common ag ents were gramnegative bacteria (56.7%), followed by gram-positive bacteria (26.7%) and fungi (16.6%), In 13 samples the cultures were negative. Nasal cultures were performed ipsilateral to the sinus drained in 28 cases. Conc ordance was obtained in only 5 (17.8%) samples, The antibiogram of the isol ated agents from the maxillary sinuses in this series revealed that the mos t efficient antibiotics were those that covered gram-negative bacteria, Tre atment was usually prolonged in these patients, and different antibiotics w ere necessary to clear infections from the sinuses. In conclusion, treating sinusitis in bone marrow transplant patients may be challenging, Considera tions about the microbiology and antibiogram susceptibilities of this speci fic population should be kept in mind when dealing with such cases.