Cases reported "Rhinitis"

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11/89. pyoderma gangrenosum of the eyelid and acute rhinosinusitis.

    pyoderma gangrenosum (PG) is a destructive, necrotizing, noninfective ulceration of the skin. Periorbital PG is extremely rare, and may progress, with eventual loss of the eye. We report a 47-year-old woman who presented with a right periorbital swelling of 8 days duration and concurrent acute rhinosinusitis. A clinical diagnosis of right periorbital PG was made, and treatment instituted with intravenous methylprednisolone and antibiotics, resulting in rapid resolution of the condition. The clinical features in this case, together with the past history of histologically confirmed PG, enabled a rapid diagnosis to be made, with early administration of treatment resulting in minimal scarring. The clinical picture could easily be confused with periorbital cellulitis, and this case demonstrates the importance of considering the differential diagnoses of periorbital swelling.
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12/89. Occupational contact urticaria caused by airborne methylhexahydrophthalic anhydride.

    Acid anhydrides are low-molecular weight chemicals known to cause respiratory irritancy and allergy. Skin allergy has on rare occasions been reported. A total of 3 subjects with occupational exposure to methylhexahydrophthalic anhydride (MHHPA) and hexahydrophthalic anhydride (HHPA) from an epoxy resin system were studied to evaluate the nature of their reported skin and nose complaints (work-related anamnesis, specific IgE, contact urticaria examinations, and ambient monitoring). Using a Pharmacia CAP system with a HHPA human serum albumin conjugate, specific IgE antibody was detected in serum from 1 (33.3%) out of the 3 workers. One unsensitized worker displayed nasal pain and rhinorrhea only when loading liquid epoxy resins into the pouring-machine (2.2 mg MHHPA/m3 and 1.2 mg HHPA/m3), probably being an irritant reaction. Two workers had work-related symptoms at relatively low levels of exposure (geometric mean 32-103 microg MHHPA/m3 and 18-59 microg HHPA/m3); one complained of only rhinitis, and the other was sensitized against HHPA and displayed both rhinitis and contact urticaria (the face and neck). The worker's skin symptoms were evidently due to airborne contact, since she had not had any skin contact with liquid epoxy resin or mixtures of MHHPA and HHPA. These urticaria symptoms were confirmed by a 20-min closed patch test for MHHPA, but not by that for HHPA. The causative agent was considered to be MHHPA, although the specific IgE determination to MHHPA was not performed.
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ranking = 15.687214981559
keywords = nasal, nose
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13/89. Peri-orbital surgical emphysema following functional endoscopic sinus surgery, during extubation.

    We present a case of peri-orbital surgical emphysema following functional endoscopic sinus surgery (FESS), due to extubation with simultaneous manual inhalation with a closed expiratory valve. This complication has not been previously reported in association with general anaesthetic and FESS. patients undergoing FESS are advised against nose blowing. However, we recommend that the anaesthetist working with a surgeon who performs FESS should also be warned not to use manual inhalation with a closed expiratory valve while extubating, as this can cause peri-orbital surgical emphysema.
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14/89. A novel case of mealworm-induced occupational rhinitis in a school teacher.

    A 47-year-old African American female elementary schoolteacher presented with itchy, watery eyes, rhinorrhea, postnasal drainage, and nasal congestion complicated by recurrent epistaxis for 2 months. She had similar symptoms the previous year from September to May but was symptom free during the summer. Her symptoms began within 1 hour after entering the classroom and improved in the evening at home, on weekends, and vacation. She denied symptoms around dust, freshly cut grass, or pets and had no prior history of underlying allergic rhinitis and asthma. She had a 20-pack-a-year smoking history but quit 1 1/2 years ago. A detailed history of her classroom environment revealed the presence of mealworms that were used to teach the children about life cycles. Physical exam revealed swollen, erythematous nasal turbinates but was otherwise unremarkable. Prick skin testing was positive for oak tree, grasses, feathers, and cockroaches. Mealworm whole body extracts were prepared using standard methodology. Titration intracutaneous skin testing revealed a positive reaction at a 1:1000 concentration associated with a large delayed reaction 8 hours later that persisted for 24 hours. Specific nasal provocation using acoustic rhinometry revealed a dose response change in nasal volume (48% decrease at 1:100; 53% decrease at 1:50) and cross-sectional area (32% decrease at 1:100; 48% decrease at 1:50) in response to mealworm challenge compared with a saline control. Removal of the mealworms from the classroom resulted in complete relief of her symptoms. This is the first reported case of mealworm-induced rhinitis in a schoolteacher. Because mealworm demonstrations are now part of the standard curriculum in public school elementary classrooms in ohio, it is important that school administrators recognize the sensitizing nature of these insects and their potential for causing allergic rhinitis and asthma in the workplace.
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ranking = 73.436074907793
keywords = nasal
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15/89. Granulomas in nasal polyps.

    Three specimens of simple nasal polyps which were examined in a routine histopathology laboratory contained tubereuloid granulomas. One of these patients was found to have systemic sarcoidosis. The other two continue to be asymptomatic and in one of these rupture of cystic nasal mucous glands with the liberation of epithelial mucin into the stroma appears to have excited the granulomatous reaction. The causation, investigation and significance of granulomas at this site are discussed.
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ranking = 88.123289889352
keywords = nasal
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16/89. Occupational respiratory hypersensitivity in dental personnel.

    OBJECTIVE: The aim was to study the causes of respiratory hypersensitivity in dental personnel based on the statistics of the Finnish Register of Occupational Diseases (FROD; 1975-1998) and the patient material of the Finnish Institute of occupational health (FIOH; 1990-1998). methods: Details about the cases of respiratory hypersensitivity were compiled from the FROD. The occupational rhinitis diagnoses studied at the FIOH were based on work-related symptoms and a change in the status of the nasal mucosa during challenge testing; and the diagnosis of occupational asthma based on reactions in challenge testing, or on IgE positivity and peak flow monitoring at work and during days off. RESULTS: A total of 64 cases of occupational respiratory diseases (ORDs) was diagnosed in dental personnel during 1975 to 1998 according to the FROD; two cases in 1975 to 1989, and 62 in 1990 to 1998. Twenty-eight cases were of occupational asthma (18 caused by methacrylates), 28 occupational rhinitis (six caused by methacrylates), seven allergic alveolitis and one organic dust toxic syndrome (ODTS). The non-acrylate-material diagnosed in 1990-1998 at the FIOH comprised three cases of asthma and one of rhinitis caused by chloramine-T (sodium- N-chlorine- p-toluene sulphonamide); as well as one case of asthma, seven cases of rhinitis, and two cases of combined rhinitis and conjunctivitis caused by natural rubber latex (NRL). Furthermore, one case of occupational rhinitis caused by Nobetec containing colophony was diagnosed. The incidence rate (IR) of ORD increased from 0 in 1988 to a peak of 105.1 new cases per 100,000 working years in 1995. During the last observation year, i.e. 1998, the IR was 55 new cases per 100,000 workers. The IR in dental personnel was lower than in the whole working population in finland up until 1992, but since then has been greater than in the whole population, peaking in 1995 when the IR of dental personnel was 2.55 times greater than in the whole population. CONCLUSION: The present study shows the increasing frequency of respiratory hypersensitivity among dental personnel. Besides methacrylates, important causes of respiratory hypersensitivity are NRL and chloramine-T.
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ranking = 18.687214981559
keywords = nasal, nose
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17/89. Allergic contact urticaria and rhinitis to roe deer (Capreolus capreolus) in a hunter.

    Roe deer (Capreolus capreolus) is one of the most common game mammals in europe, where hundreds of thousands people are exposed to this animal. Despite this fact, we are aware of only two cases of allergy to roe deer published until recently, one case of allergic rhinoconjunctivitis and asthma and the second of contact urticaria. We describe another case with co-existing allergic contact urticaria and rhinitis in a 55-year old male professional hunter. The symptoms were provoked only by exposure to roe deer, and there were no other past or present allergic diseases. Specific IgE was found to following animal allergens: cow dander (CAP class 5), goat epithelium and horse dander (each CAP class 4), dog epithelium, dog dander and swine epithelium (each CAP class 2). Skin prick tests have shown positive reaction only to cow epithelium ( ). Because of lack of deer dander allergen for specific IgE and skin tests, we have confirmed the causal relationship between exposure to roe deer and allergy using the rub test with roe deer's fur. There was a clearly positive urticarial reaction on the patient's skin accompanied by nasal itch, sneezing and rhinorrhea. No reaction was seen in a control person. We surmise that the positive tests with cow epithelium seen in this patient may result from a cross-reactivity to deer allergens. We conclude that although occupational allergies to roe deer seem to be rare, such possibility should be always considered among people having contact with these animals.
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ranking = 14.687214981559
keywords = nasal
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18/89. acanthamoeba: a rare primary cause of rhinosinusitis.

    Parasitic infections, especially acanthamoeba, are rarely implicated as a specific cause of rhinosinusitis. It is a fatal disease found in the immunocompromised population, in particular in patients infected with the human immunodeficiency virus (hiv). Less than 10 cases of Acanthamebic rhinosinusitis have been reported in the literature, and only 1 has survived. This case report presents an Acanthamebic infection misdiagnosed as a squamous cell carcinoma of the nasal septum on a presumptive healthy, immunocompetent 35-year-old woman. She was later diagnosed with AIDS (AIDS) along with disseminated Acanthamoebiasis and became the second reported case surviving this deadly illness. This case report also discusses the difficulty in diagnosing this rare parasite, the pathogenesis, and the multidisciplinary treatment required to control and manage this uniformly fatal disease.
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ranking = 16.687214981559
keywords = nasal, nose
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19/89. Eosinophilic fungal rhinosinusitis of the lacrimal sac.

    OBJECTIVES/HYPOTHESIS: Chronic sinusitis is a condition affecting millions of individuals each year. Recent findings indicate that chronic rhinosinusitis is a response to fungi mediated by the eosinophil in some of these individuals. We report a case of eosinophilic fungal rhinosinusitis of the lacrimal sac, an entity not previously reported. STUDY DESIGN: Case report. methods: A 69-year-old man presented with a 1-cm cystic lesion in the right-side medial canthal region. This lesion was fluctuant, and mucoid material was freely expressed from the medial canthal area. Endoscopic examination revealed bilateral nasal polyps anteriorly and superiorly with mucopurulent drainage from both maxillary sinuses. He had undergone three prior sinus surgeries and two prior lacrimal cannulations elsewhere. A computed tomography scan showed opacification of both maxillary sinuses, ethmoid sinuses, and the left sphenoid sinus and moderate thickening in the frontal sinuses. There was significant soft tissue prominence in the area of both lacrimal fossae with erosion into the medial orbit. The patient underwent bilateral endoscopic revision ethmoidectomies, middle meatal antrostomies, sphenoidotomies, frontal sinusotomies, and endoscopic right-side dacryocystorhinostomy at the Department of Otorhinolaryngology, Mayo Clinic (Rochester, MN). RESULTS: At the time of surgery, massive amounts of thick mucoid material were aspirated from both lacrimal regions. The aspiration of the lacrimal duct on the left side was sufficient treatment, whereas the dacryocystorhinostomy was necessary to decompress the cyst of the face on the right side. The material aspirated was allergic mucin, and the patient met the criteria for diagnosing eosinophilic fungal rhinosinusitis. The patient was started on a regimen of antifungal nasal irrigations postoperatively and has done well in follow-up. CONCLUSIONS: Although never previously reported, eosinophilic fungal rhinosinusitis can occur in the lacrimal sac. It is important to recognize this so that the underlying disease process can be treated appropriately.
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ranking = 29.374429963117
keywords = nasal
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20/89. pregnancy rhinitis and rhinitis medicamentosa.

    PURPOSE: To present guidelines for the recognition, management, and referral of pregnancy rhinitis with a goal of improving the quality of the pregnancy experience for women afflicted with this condition. DATA SOURCES: A case study illustrating the presentation of a severe case of pregnancy rhinitis is followed a literature review of etiology, diagnosis, and management strategies. CONCLUSIONS: pregnancy rhinitis is a condition of clinical importance that is frequently exacerbated by use of intranasal decongestant sprays. The resulting rhinitis medicamentosa exacerbates the nasal obstruction, with resulting sleep disruptions that negatively impact the experience of pregnancy. IMPLICATIONS FOR PRACTICE: nurse practitioners may miss opportunities to provide support, anticipatory guidance, and symptom relief. Anticipatory guidance that stresses the critical necessity of avoiding nasal spray decongestants, environmental modification, use of intranasal saline, moderate exercise, and nasal strips for subjective relief may have the potential to markedly decrease escalation of the condition to a serious disorder.
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ranking = 73.436074907793
keywords = nasal
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