Differentiating Rhinitis in the Paediatric Population by Giving Focus on Medical History and Clinical Examination

Doulaptsi, Maria; Aoi, Noriaki; Kawauchi, Hideyuki; Milioni, Athanasia; Karatzanis, Alexander; Prokopakis, Emmanuel

In allergic rhinitis, nasal symptoms are classically associated with exposure to an allergen to which the patient is sensitized [1] . Classic symptoms are nasal obstruction, watery rhinorrhoea (anterior or posterior), pruritus, and sneezing (especially paroxysmal) which typically occur immediately after allergen exposure and may last for hours. By definition, the presence of two or more of the aforementioned symptoms for >1 h on most days indicates AR [1, 18] . Red, itchy eyes are suggestive of conjunctivitis of allergic origin, which strongly correlates with AR. In young children, AR may have atypical presentation [1] . Reduced hearing, pruritic mouth and throat, sleep disorders, cough, poorly controlled asthma, and eczema are potential symptoms indicating AR [10] . History again is of great importance. Symptoms which occur on only one side of the nose, thick discoloured secretions, nasal obstruction without other symptoms, facial pain, epistaxis, and loss of smell are typically not found in AR. The presence of any one of them suggests that an alternative diagnosis is possible and should be investigated. Response to previous treatment should also be taken into account, as this may provide additional clinical insight [10] .