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Allergic rhinitis
From WikEM
Contents
Background
- Also called hay fever - inflammation of the nasal mucosa secondary to allergens in the air.
Clinical Features
- Patient present with a constellation of symptoms
- thin clear rhinorrhea (if thick or discolored, consider infectious causes)
- sneezing
- itching of the nose
- nasal congestion
- nasal obstruction
- clogged feeling in the ears
- triggers often easily identified
- animals
- season changes
- symptoms last until triggers are removed
- should not have fevers
Differential Diagnosis
- viral upper respiratory infection
- bacterial upper respiratory infection
- acute sinusitis
- chronic sinusitis
- fungal sinusitis
- nasal polyposis
- nasal mass
- nasal foreign body
Evaluation
- Clinical diagnosis
- ensure no signs of bacterial infection
Management
- Saline nasal irrigation (netipot) twice a day- washes out allergens
- combination of topic nasal steroids (flonase, nasonex) and/or nasal antihistamines (patanase). Must be used for several weeks before symptomatic relief is realized
Disposition
- Discharge home
- Allergist referral if nasal sprays not helping
- ENT referral to evaluate for the need for sinus surgery which may help by opening up the sinuses allowing for better distribution of topical medications
