Is staph the cause of recurrent epistaxis?
30 Mar 03 QI have been told to treat all children with recurrent epistaxis with Naseptin for two weeks before referral for cautery. Is there good evidence that staph infection is the cause? AEpistaxis is extremely common between the ages of three and eight. Recurrent epistaxis can be both socially disabling and a cause for significant parental concern. First-line treatment typically involves the use of an antiseptic cream such as a chlorhexidine/neomycin (Naseptin) and nasal cautery is often performed. The aetiology of epistaxis is often multifactorial, and coagulopathy should always be considered as a rare but potentially serious cause. But there is little doubt inflammation, often as a result of upper respiratory tract infection, plays an important role. This may lead to crusting and local trauma from nose rubbing and picking, which often causes bleeding of the hyperaemic mucosa directly, and may predispose to secondary bacterial infection and vestibulitis. A vicious circle can devel
