Repeated Viral Infections in Pediatric Chronic Rhinosinusitis: Insights from Longitudinal Follow-Up at a Single Institution

Monday, October 13, 2025

9:36 AM - 9:42 AM EDT

Location: 233-234

Disclosure(s):

Mary C. Wilding, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Amanda L. Stapleton, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Chronic rhinosinusitis (CRS) is postulated to be caused by microbiome dysbiosis, reducing diversity and triggering a cycle of infection, inflammation, and anatomic remodeling. This study examines whether repeated viral infection in sinonasal mucosa contributes to this cycle in sinonasal disease.

Methods: Pediatric patients undergoing sinus surgery for CRS (cystic fibrosis (CF) group and non-CF CRS group) at a tertiary children’s hospital were enrolled. Sinus swabs were collected at time of operation and follow up for up to three years (2019-2022). An 11-virus panel was run. Clinical, endoscopic, and operative data were recorded. Associations of repeated viral infections, endoscopic findings, and symptoms were evaluated using Fisher’s Exact Test.

Results: Among the 36 CF and non-CF CRS patients enrolled in the study, 24 patients had follow-up evaluations, yielding a total of 136 swabs. The cohort consisted of 14 patients in the CF group (50% male, average age at initial operation: 12.58±4.01 years, average follow-up length: 19.80±13.29 months) and 10 patients in the non-CF CRS group (40% male, average age at initial operation: 16.32±4.50 years, average follow-up length: 8.61±12.21 months). Repeated viral infection across multiple visits occurred in 64.23% of patients in the CF group (n=9/14) and 30% of patients in the non-CF CRS group (n=3/10), most commonly with human rhinovirus.
Endoscopic findings from all visits showed patients with repeated viral infections were more likely to have edema (53/91 vs 13/44, p=0.007), while those without repeated viral infections were more likely to have crusting (33/44 vs 46/91, p=0.009). Of those with repeated viral infection, symptomatic drainage was more frequent during times of viral infection (36/36 vs 25/55, p=0.017), with no differences in cough, headache, or sinus pressure.

Conclusions: Repeated viral infections are common in children with CRS and appear to correlate with disease severity. Further monitoring of viral infection patterns with endoscopic findings and clinical presentation is needed to improve understanding of their role in clinical management of CRS.

Presenting Author(s)

Mary C. Wilding, BS

Medical Student
University of Pittsburgh School of Medicine
Pittsburgh, PA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

GR

Glenn J. Rapsinski, MD, PhD

Assistant Professor
Department of Microbiology and Molecular Genetics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
Pittsburgh, PA, United States

Disclosure information not submitted.
Amber D. Shaffer, PhD

Research Assistant Professor
UPMC Children's Hospital of Pittsburgh
Pittsburgh, PA, United States

Disclosure information not submitted.
JB

Jennifer Bomberger, PhD

Department of Microbiology and Immunology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire., United States

Disclosure information not submitted.
JW

John Williams, MD

Department of Pediatrics, University of Wisconsin, United States

Disclosure information not submitted.
MJ

Monika Johnson, n/a

UPMC Children’s Hospital of Pittsburgh, United States

Disclosure information not submitted.

Senior Author(s)

AS

Amanda L. Stapleton, MD

Associate Professor Of Otolaryngology
Childrens Hospital of Pittsburgh of UPMC
Pittsburgh, PA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.