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Medical Forum / Diseases and Disorders / Sinusitis / June 2005Tsunami sinusitis
from the new issue of the NEJM A 35-year-old man was brought to the hospital after sustaining injuries associated with the tsunami in Southeast Asia on December 26, 2004. The patient had inhaled seawater when he nearly drowned. In addition, he had sustained multiple injuries, including a scalp laceration and torn right anterior cruciate and medial collateral ligaments. He had sinus discomfort but no difficulty breathing. Computed tomographic scanning showed fluid and opaque material in the ethmoid (Panel A, arrowhead), maxillary (Panel B, arrowhead), and sphenoid sinuses (Panel C, arrowhead). (For comparison, normally aerated sinuses from another patient can be seen in the Supplementary Appendix, available with the full text of this article at www.nejm.org.) The patient underwent bilateral antral washout, during which green-colored purulent material and sand were removed. Culture of material obtained from the maxillary sinuses showed Aeromonas veronii, Klebsiella pneumoniae, and Escherichia coli on the right side and E. coli, A. hydrophila, and Proteus mirabilis on the left side. The patient received antimicrobial therapy and repair of his right knee ligaments and made a full recovery. http://content.nejm.org/cgi/content/full/352/25/e23?query=TOC You can see his CT scan via the link. On 6/22/05 7:01 PM, in article d-ydnT3laNVYiiffRVn-ig@comcast.com, > from the new issue of the NEJM > [quoted text clipped - 19 lines] > > You can see his CT scan via the link. Which brings up my question; Given a choice, would you rather sustain a 5 inch foot gash - laceration in a filthy warehouse or in the ocean? My preference is the filthy warehouse - actually cleaner re major bacteria. And this is why I do not recommend sea salt for nasal irrigation. They are supposed to take out the bacteria and fish excreta but ... > And this is why I do not recommend sea salt for nasal irrigation. Good point Dr Grossan. I'll delete any reference to sea salt next time someone asks me what formula of salt mix I use. I've only been irrigating for a year now so my salt experience is limited. I have tried 6-8 various different types of salt available locally and found that several types (including most sea salts) were visibly dirty. I never had the idea that sea salt was in some way better than the plain salts I have tried. I had just been pleased with the purity of a Canadian brand named Lifestream sea salt which at least to my eye appeared very pure. The Lifestream looks in appearance like the more expensive Kosher salt and both these types blend up easily. There is certainly no point in my using distilled water for mixing saline if the salt I'm using might be dirty. I do hate using a salt where every now and then you see an unidentified speck of something or other running out your nose in the water. I'll investigate further into what types of non-sea salt are available locally that don't have caking agents in them. thanx, AW On 6/24/05 6:55 PM, in article LM-dnYSZ4rz7JCHfRVn-jQ@comcast.com, >> And this is why I do not recommend sea salt for nasal irrigation. > [quoted text clipped - 19 lines] > > thanx, AW Kosher or pickling salt is free of anticaking or iodine products. But for most persons regular store salt - Morton's, etc works OK. Only some persons are sensitive to the iodine or the anticaking product. As to what's in Sea Salt its G O K. God only knows. Its evaporated sea water that can contain any and all kinds of stuff. More important there may be chemicals there that you can become sensitzed to. Put it another way - I regularly see a patient whose ONLY nasal problem is the benzalkonium preservative or the G.O.K. Sea salt product. What annoys me is that you pay much more for the sea salt ! I once saw a 2 ounce bottle of sea salt liquid for $7.95 and of course it contained benzalkonium! Breathe.ease is not regular salt. It is a saline mix of electolytes existing in your body. Once your nose/sinus is healed, you can go back ot regular Kosher or similar salt.
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