What Is the Role of Chlamydia pneumonia in Rhinosinusiits of Children?

Chlamydia pneumoniae is a common respiratory pathogen which is often found in our paediatric populations. Many patients with community-acquired pneumonia caused by C. pneumoniae have symptoms suggestive of sinusitis.the role of C. pneumonia in rhinosinusiits children (Meanage =4.3 ±2.5year). This case control study was done in the pediatric and ENT clinics of Hazrat Rasul Hospital in Tehran (2004-2005). This study based on diagnostic parametersfor rhinosinusitis cases and controls .Serum Specific antibodies (IgG & IgM) against Chlamydia. Pneumonia detected in 51 cases and 31 controls. Nasopharyngeal swabsfor detection the Chlamydia.p –DNA by PCR used in all cases and controls. Acute infection (IgM) obtained in 11%(6/51); previous immunity (IgG) in none(0/51) of rhinosinusitis cases.Acute infection (IgM) detected in 6.5% (2/31);previous immunity (IgG) in 13.3%(4/31) of controls and dependent to age (P=000). Acute infection( IgM)had not significant difference (P= 0.7) between cases and controls but previous infection(IgG) was significantly higher in controls (0.007).Active infection(DNA- PCR )not obatained in cases . Acute infection (IgM)in cases was twice higher than controls.None of cases had previous immunity to chlamydial infection (IgG). It was significantly lower thanhealthy controls (P =0.01). These serological results had different results in compare with its role in pneumonia study but it was closer to adenoid study (16%). Adenoid may act as a reservoir for bacteria causing sinusitis, lung and chronic ear infection.We recommend specific antibiotics for C. pneumonia in resistant sinusitis to usual drugs especially in cases accordance with adenoiditis and adenoid hypertrophy before surgery.