Clinical and microbiological features of pathology of the nose and paranasal sinuses in patients with community-acquired pneumonia

This article presents the results of a comprehensive otolaryngological and microbiological study of diseases of the nose and paranasal sinuses in patients with community-acquired pneumonia. These diseases are closely interconnected, since the upper and lower respiratory tract are a single whole, have structures and functions and mechanisms for the development of pathological conditions. The etiopathogenesis of bacterial inflammatory diseases of the upper and lower respiratory tract is based on the disruption of the integrity of epithelial cells under the influence of respiratory viruses. Under the influence of the general toxic effect of the virus, phagocytosis is inhibited, immunological protection is disrupted, resulting in favorable conditions for microbial colonization in the nasopharynx and further spread of infections to the paranasal sinuses and lower respiratory tract. As a result of the clinical and microbiological study, it was revealed that inflammatory diseases of the nose and paranasal sinuses such as acute and chronic rhinosinusitis, allergic and vasomotor rhinitis, and deviated nasal septum were often encountered in community-acquired pneumonia. To determine the nature of the microbial landscape of the upper and lower respiratory tract, a comparative microbiological analysis of the nose and sputum was carried out. The analyzes showed that no significant difference in pathogenic microflora was detected between the upper and lower respiratory tract. The main pathogen in both diseases was Streptococcus pneumoniae. The correspondence of the pathogenic microflora of the nasal cavity and lower respiratory tract when detecting rhinosinusitis in patients with community-acquired pneumonia confirms the pathogenetic relationship of inflammatory processes in these organs, as well as the need for parallel diagnostics, treatment, and prevention.