Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • nasal congestion
  • postnasal drainage
  • rhinorrhea
  • sore throat

Other diagnostic factors

  • ear plugging
  • sinus headaches
  • postural change triggers
  • absence of fever
  • sneezing
  • purulent discharge
  • bilateral symptoms
  • sinus pain

Risk factors

  • symptom onset age >35
  • no seasonal symptoms
  • no symptom exacerbation by cats
  • exposure to fragrance
  • exposure to smoke (e.g., wood, tobacco)
  • exposure to hairspray
  • exposure to potpourris
  • changes in temperature
  • barometric changes
  • no family history of allergies
  • high estrogen state
  • beta-blocker use
  • intranasal drug abuse

Diagnostic investigations

1st investigations to order

  • allergy prick skin tests
  • serologic specific IgE testing
Full details

Investigations to consider

  • nasal eosinophil smear
  • sinus CT
  • nasal endoscopy
  • nasal provocation test
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Professor of Clinical Medicine

Department of Internal Medicine

Division of Immunology/Allergy Section

University of Cincinnati College of Medicine

Cincinnati

OH

Disclosures

JAB has acted as a consultant for Inflamax, MEDA, GSK, and ATL, and serves on a medical safety board for HAL Allergy; is a principle investigator or sub-principle investigator for over 30 pharmaceutical companies; has an investigator-initiated research project from Shire; is a protocol chair for a U44 clinical trial funded by NAIAD; is a speaker for AZ, Shire, and CSL Behring; and is an author of a number of references cited in this monograph.

Professor Bernstein would like to gratefully acknowledge Dr Chris Codispoti, a previous contributor to this monograph. CC declares that he has no competing interests.

Peer reviewers VIEW ALL

Associate Member

St. Jude Faculty Director

Pediatric Infectious Diseases Fellowship Program

Memphis

TN

Disclosures

EEA declares that she has no competing interests.

Chief

ENT Department

Istanbul Training and Research Hospital

Istanbul

Turkey

Disclosures

OY declares that he has no competing interests.

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