rhinitis%20-%20nonallergic%20(pediatric)
RHINITIS - NONALLERGIC (PEDIATRIC)
Rhinitis is the inflammation of the nasal lining membranes.
Nonallergic rhinitis is a diagnosis of rhinitis without any immunoglobulin E (IgE) mediation, as documented by allergen skin testing.
Signs & symptoms are nasal itching, rhinorrhea, nasal congestion with or without obstruction and sneezing.

Rhinitis%20-%20nonallergic%20(pediatric) Diagnosis

Diagnosis

  • A detailed clinical history & physical exam should be obtained to rule out other nasal conditions that may mimic signs & symptoms of rhinitis

History

  •  Nasal congestion and postnasal drip are the more common presenting symptoms compared to allergic rhinitis
  • Previous negative allergy testing
  • Sensitivity to smoke, perfume, environmental irritants & changes in weather conditions
  • Overuse of topical decongestants
  • Nasal crusting or drying
  • Facial pain

Physical Examination

Nasal Exam
  • Can be carried out using a nasal speculum (anterior rhinoscopy) or by endoscopy
    • Endoscopy is indicated when symptoms persist despite treatment; for assessment of nasal perforations, ulceration & polyps
  • May reveal the following:
    • Mucosa may be edematous, hyperemic or pale
    • Swollen nasal turbinates (note size & color)
    • Rhinorrhea with clear, cloudy or colored discharge
      • Bacterial sinusitis is considered if colored discharge is noted
    • Mouth breathing especially in chronic congestion
  • Patient should be referred to a specialist if findings are more consistent with a structural etiology than rhinitis (eg tumors, nasal polyps, septal deviation, adenoidal hypertrophy, etc)
Other physical findings may include:
  • Enlarged tonsils
  • Lymphadenopathy
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS JPOG - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
Elaine Soliven, 3 days ago

Switching from efavirenz/emtricitabine/tenofovir disoproxil fumarate (EFV/FTC/TDF) to the new bictegravir/ emtricitabine/tenofovir alafenamide (BIC/FTC/TAF) regimen maintained high rates of virological suppression in adults who are living with HIV*, according to a study presented at AIDS 2020.

01 Aug 2020
Supplementation with probiotics may have positive effects in patients with type 2 diabetes mellitus (T2DM), reports a recent meta-analysis.
Stephen Padilla, 4 days ago
Pre-exposure prophylaxis (PrEP) containing either long-acting injectable cabotegravir (CAB) or tenofovir/emtricitabine (TDF/FTC) is safe and effective for transgender women (TGW) and cisgender men who have sex with men (MSM), but CAB results in a much lower HIV incidence compared to TDF/FTC, results of the HIV Prevention Trials Network (HPTN) 083 have shown.
Jairia Dela Cruz, 3 days ago
Monthly prophylaxis with the fixed-dose combination of naphthoquine-azithromycin (NQAZ) is well tolerated and confers significant protection against infection with Plasmodium parasites among individuals residing in malaria-endemic areas in Southeast Asia, as shown in the results of a phase III trial.