Enterococcus faecalis as an uncommon pathogen in acute rhinosinusitis: a case report with surgical management
Year: 2025
Type: article
Study design: Case Report
Abstract: Introduction. Acute bacterial sinusitis in immunocompetent adults is typically caused by Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis. Enterococcus faecalis is a rare etiologic agent in sinonasal infections, being usually linked to nosocomial settings, immunosuppression or chronic disease. Case presentation. We present the case of a previously healthy 27-year-old man with acute exacerbation of chronic rhinosinusitis, presenting with severe unilateral headache, palpebral necrosis and purulent nasal discharge. The patient was managed with broad-spectrum intravenous antibiotics and underwent combined endoscopic sinus surgery and external frontal sinus drainage (modified Ogston-Luc procedure). Culture of the collected material identified Enterococcus faecalis as the primary pathogen. Discussion. This case highlights an unusual presentation of acute complicated sinusitis caused by Enterococcus faecalis in an otherwise healthy young adult. While rarely implicated in community-acquired rhinosinusitis, its detection should prompt consideration of resistance mechanisms, biofilm formation and suboptimal hygienic factors. Early surgical intervention and microbiological identification were essential in guiding the effective antibiotic therapy. Conclusions. Enterococcus faecalis may represent an emerging, atypical pathogen in sinus infections even in low-risk individuals. Accurate diagnosis, prompt surgical management and culture-directed therapy are critical in avoiding complications and ensuring optimal clinical outcomes.
Source: ORL ro
Language: English
Subfield: Otorhinolaryngology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4412896526