rhinitis
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Introduction
Inflammation of the nasal mucosa. Coryza is acute rhinitis.
Etiology
- allergic rhinitis
- infectious agents
- non-infectious
- vasomotor rhinitis
- smoke
- air pollution
- perfumes
- detergents & soaps
- solvents or fumes
- changes in temperature, light, or atmospheric pressure
- emotion
- rhinitis medicamentosa
- sympathomimetic nasal drops or sprays
- cocaine
- antihypertensives
- oral contraceptives
- antidepressants
- also see nasal congestion
- nasal obstruction
- systemic disorders
- cerebrospinal fluid leak (CSF rhinorrhea)
- atrophy of nasal mucosa
- vasomotor rhinitis
Clinical manifestations
- congestion, rhinorrhea, sneezing, & pruritus typical of allergic rhinitis[6]
- congestion & postnasal drainage without pruritus typical of nonallergic rhinitis
Differential diagnosis
- sinusitis
- congestion & anosmia common in chronic sinusitis with nasal polyps[6]
Management
- antibiotics for patients with bacterial sinusitis[4] otherwise, antibiotics not indicated
- nasal glucocorticoids &/or nasal antihistamines
- intranasal glucogorticoids first line for allergic rhinitis
- start working in 2 hours but may take up to 2 weeks for full effects
- intranasal antihistamines provide relief in 15-30 minutes
- use only 2nd generation antihistamines in allergic thinitis[6]
- intranasal glucogorticoids first line for allergic rhinitis
- intranasal decongestants (oxymetazoline [Afrin]):
- limit to short-term use to prevent rebound congestion
- in patients with severe refractory congestion, they can be combined with intranasal glucocorticoids for as long as 4 weeks.[6]
- evidence does not support adding an oral medication to an intranasal spray
- montelukast rarely useful for allergic rhinitis
- avoid with non-allergic rhinitis[6]
- montelukast rarely useful for allergic rhinitis
- also see allergic rhinitis, vasomotor rhinitis or other specific etiology
More general terms
More specific terms
- allergic rhinitis (hay fever, ragwood allergy)
- common cold; acute nasopharyngitis; viral rhinosinusitis
- nasopharyngitis; rhinopharyngitis
- nonallergic vasomotor rhinitis
- rhinitis medicamentosa
- rhinosinusitis
Additional terms
References
- ↑ Taber's Cyclopedic Medical Dictionary, FA Davis, Philadelphia, 1977
- ↑ Stedman's Medical Dictionary 26th ed, Williams & Wilkins, Baltimore, 1995
- ↑ Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998
- ↑ 4.0 4.1 Arrol B and Kenealy T Are antibiotics effective for acute purulent rhinitis? Systematic review and meta-analysis of placebo-controlled randomised trials. BMJ 2006, 333:279 PMID: https://www.ncbi.nlm.nih.gov/pubmed/16861253
- ↑ Wallace DV, Dykewicz MS, Bernstein DI et al Joint Task Force on Practice; American Academy of Allergy; Asthma & Immunology; American College of Allergy; Asthma and Immunology; Joint Council of Allergy, Asthma and Immunology. The diagnosis and management of rhinitis: an updated practice parameter. J Allergy Clin Immunol. 2008 Aug;122(2 Suppl):S1-84. PMID: https://www.ncbi.nlm.nih.gov/pubmed/18662584
- ↑ 6.0 6.1 6.2 6.3 6.4 6.5 Dykewicz MS et al. Rhinitis 2020: A practice parameter update. J Allergy Clin Immunol 2020 Oct; 146:72 PMID: https://www.ncbi.nlm.nih.gov/pubmed/32707227 https://www.jacionline.org/article/S0091-6749(20)31023-X/fulltext
- ↑ Acute rhinosinusitis in Adults: Guidelines for Clinical Care University of Michigan Health System http://cme.med.umich.edu/pdf/guideline/rhino05.pdf