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We undertook this study to investigate the possible association among these diseases. Children younger than 18-year-old with a diagnosis of bacterial conjunctivitis plus acute otitis media and\/or acute bacterial paranasal sinusitis during 2009\u20132018 were included. Sampling for bacterial cultures was obtained from the lower palpebral conjunctiva and\/or ear discharge with cotton-tipped swabs. A total of 67 children were recruited and the age was 29.5 (\u00b1\u200922.4) months in average. Fifty-seven children had conjunctivitis\u2013otitis media syndrome and eight of them had a concurrent diagnosis of acute paranasal sinusitis. Ten children had conjunctivitis and acute paranasal sinusitis simultaneously. Clusters in household were observed in 50.7% children. Most common isolates were <jats:italic>Haemophilus influenzae<\/jats:italic> (70%), <jats:italic>Moraxella catarrhalis<\/jats:italic> (18%), and <jats:italic>Staphylococcus aureus<\/jats:italic> (8%). Antibiotic resistance rate of <jats:italic>H. influenzae<\/jats:italic> was 80% for ampicillin, 18% for amoxicillin\u2013clavulanate, and 11% for the second or third-generation cephalosporins. Apart from well-known conjunctivitis\u2013otitis media syndrome, acute paranasal sinusitis may also be linked to conjunctivitis with a similar pathogenic process. Simultaneous presence of these infections may guide the choice of empiric antibiotics toward <jats:italic>H. influenzae<\/jats:italic>.<\/jats:p>","DOI":"10.1038\/s41598-020-79680-6","type":"journal-article","created":{"date-parts":[[2021,1,8]],"date-time":"2021-01-08T11:13:01Z","timestamp":1610104381000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":51,"title":["Predominant role of Haemophilus influenzae in the association of conjunctivitis, acute otitis media and acute bacterial paranasal sinusitis in children"],"prefix":"10.1038","volume":"11","author":[{"given":"Ya-Li","family":"Hu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping-Ing","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Po-Ren","family":"Hsueh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun-Yi","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luan-Yin","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Min","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tu-Hsuan","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jong-Min","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,1,8]]},"reference":[{"key":"79680_CR1","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1542\/peds.38.1.25","volume":"38","author":"JD Coffey Jr","year":"1966","unstructured":"Coffey, J. 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