New-Onset Bacterial Sinusitis in Pediatric Liver Transplant Recipients; Case Series and Review of Literature

Background As a standard measure in some chronic liver disorders, liver transplantation (LT) is being performed for about three decades in pediatric populations. In the post- operative period, some patients suffer from infectious complications by viral, bacterial, and fungal etiologies. Here we present 10 children diagnosed with bacterial sinusitis along with prolonged fever and upper respiratory tract symptoms post LT and review the literature. Case Presentation Ten pediatric LT recipients, including seven boys and three girls, aged 1.5 to 8 years (4.7±2.34) with a mean weight of 15.6+4.8 Kg (range; 11.4–27.5 Kg), were diagnosed with bacterial sinusitis from December 2013 to March 2017. The patients were suffering from respiratory symptoms and prolonged fever. After ruling out other diagnosis and by performing a thorough investigation, we confirmed bacterial sinusitis by sputum culture and antibiogram and paranasal computed tomography (CT) scan. All the patients dramatically responded to intravenous broad-spectrum antibiotics. Conclusion In the post-LT period, for patients suffering from fever or prolonged fever with upper respiratory signs and symptoms, acute sinusitis should be kept in mind. Therefore, timely diagnoses, coupled with therapeutic measures using broad-spectrum antibiotics, could prevent disease progression and complications.