II. Causes
- See Rhinitis Causes
III. History
- Duration of symptoms <1 week
- Viral Rhinitis
- Allergic Rhinitis Exacerbation
- Chronic symptoms that follow pattern of triggers
- Seasonal or Perennial Allergic Rhinitis
- Other causes
- Drug-Induced Rhinitis
- Exercise-induced Rhinitis
- Gustatory Rhinitis or other food reactions
- Vasomotor Rhinitis
- Irritant Rhinitis
- Unilateral Rhinorrhea
- Choanal Atresia
- Nasal Foreign Body (especially in young children)
- Nasal Neoplasm
- Cerebrospinal Fluid Rhinorrhea
- Underlying medical conditions
- Hypothyroidism
- Rheumatoid conditions (e.g. SLE, Sjogren's Syndrome)
- Gastroesophageal Reflux
IV. Examination
- Eyes
- Ears
- Eustachian Tube Dysfunction (chronic congestion)
- Nose
- Nose breathing difficult (chronic congestion)
- Deviated septum
- Nasal Polyps
- Purulent nasal drainage (Acute Sinusitis)
- Mouth
- Tonsil hypertrophy (Non-allergic Rhinitis)
- Neck
- Respiratory
- Wheezing (Asthma and Atopic Triad)
- Skin
V. Diagnostics
-
Eosinophils on nasal drainage evaluation
- Suggests Allergic Rhinitis or Eosinophilia Syndrome
- Allergy evaluation
- Skin Testing for allergy
- RadioAllergoSorbent Test (RAST)
VI. Differential Diagnosis
-
Allergic Rhinitis
- Sneezing and Pruritus with seasonal variation
- Pale, boggy nasal mucosa
- Family History of Allergic Rhinitis or atopy
- Allergen exposure or positive Allergy Testing
-
Non-allergic Rhinitis
- See Rhinitis Causes
- Perennial symptoms
- Post-nasal drainage
- Erythematous nasal mucosa
- Irritant exposure and negative Allergy Testing