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 the paediatric population, limitations in history taking, clinical examination, and laboratory/imaging investigation make the diagnosis of rhinitis a challenging process. For instance, we rely on parental accuracy for the information provided as medical history, especially with preschool-aged patients. Physicians refrain from submitting young patients to multiple tests (i.e., endoscopy, allergy tests, computed tomography (CT)) in order to diagnose, characterize, and differentiate rhinitis from other diseases. The lack of cooperation is another major issue, especially for younger patients. Additionally, co-morbidities related to rhinitis, should be sought and identified to lead to correct diagnosis and management. Conjunctivitis, chronic rhinosinusitis (CRS), asthma, adenoidal hypertrophy, sleep, learning, and speech disorders, as well as otitis media with effusion appear to be the most common co-morbidities of rhinitis in paediatric population. Physicians should also be aware of other rare clinical entities mimicking chronic rhinitis in paediatric patients, like immunodeficiency, cystic fibrosis (CF), and primary ciliary dyskinesia (PCD) [7, 8] . Herein, we assess key features of the diagnostic process of rhinitis in the paediatric population. Special focus was given to medical history, inspection, and physical examination. Diagnostic tests and treatment are beyond the scope of this study.