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