ATROPHIC RHINITIS

Chronic infection of the nasal mucosa in which various components become thinner (atrophy) due to fibrosis of the
terminal blood vessels

Cause

  • Unknown but associated with: HIV/AIDS, poor socioeconomic status, syphilis, rhinoscleroma (early stages)

Clinical features

  • Tends to affect both nasal cavities
  • Affects females more than males
  • Foul stench not noticed by patient who cannot smell
  • Crusts and bleeding points in the nose
  • Epistaxis when crusts separate
  • Sensation of obstruction in the nose
  • Nasal airway very wide

Investigations

  • C&S of smear of nasal material
  • X-ray: To exclude sinusitis
  • Differential diagnosis
  • Atrophy from other causes

MANAGEMENT

  • Clean nasal cavities twice daily to remove crusts (most important)
  • Syringe nose or douche it with warm normal saline
  • Or sodium bicarbonate solution 5% (dissolve 1 teaspoon of powder in 100 ml cup of warm
    water)
  • Then apply tetracycline eye ointment 1% inside the nose twice daily
  • Give amoxicillin 500 mg every 8 hours for 14 days
    • For rhinoscleroma: Give 1 g every 8 hours for 6 weeks

If atrophic rhinitis not better or is worse after 2 weeks

  • Refer to ENT specialist

Prevention

  • Treat/eliminate known causes, such as syphilis