Allergic rhinitis

Background

  • Also called hay fever - inflammation of the nasal mucosa secondary to allergens in the air.

Clinical Features

  • Constellation of symptoms:
    • Thin, clear rhinorrhea (if thick or discolored, consider infectious causes)
    • Sneezing, itching of the nose
    • Nasal congestion and/or obstruction
    • Clogged feeling in the ears
  • Common triggers:
    • Animals
    • Environmental (e.g. grassess, pollens); often symptomatic with seasonal changes
  • Symptoms last until triggers are removed
  • Should not have actual fever

Differential Diagnosis

Rhinorrhea

Evaluation

  • Clinical diagnosis
  • Rule out bacterial infection

Management

  • Reduce exposure to allergen
    • If environmental, sleep with windows closed, change clothes and/or shower when returning home after being outdoors
  • Saline nasal irrigation (neti pot) 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
    • Consider allergist referral if nasal sprays not helping
    • Consider ENT referral to evaluate for the need for sinus surgery, which may be help by opening up the sinuses allowing for better distribution of topical medications

See Also

External Links

References