II. Causes

III. History

  1. Duration of symptoms <1 week
    1. Viral Rhinitis
    2. Allergic Rhinitis Exacerbation
  2. Chronic symptoms that follow pattern of triggers
    1. Seasonal or Perennial Allergic Rhinitis
    2. Other causes
      1. Drug-Induced Rhinitis
      2. Exercise-induced Rhinitis
      3. Gustatory Rhinitis or other food reactions
      4. Vasomotor Rhinitis
      5. Irritant Rhinitis
  3. Unilateral Rhinorrhea
    1. Choanal Atresia
    2. Nasal Foreign Body (especially in young children)
    3. Nasal Neoplasm
    4. Cerebrospinal Fluid Rhinorrhea
  4. Underlying medical conditions
    1. Hypothyroidism
    2. Rheumatoid conditions (e.g. SLE, Sjogren's Syndrome)
    3. Gastroesophageal Reflux

IV. Examination

  1. Eyes
    1. Allergic Shiners
    2. Allergic Conjunctivitis
  2. Ears
    1. Eustachian Tube Dysfunction (chronic congestion)
  3. Nose
    1. Nose breathing difficult (chronic congestion)
    2. Deviated septum
    3. Nasal Polyps
    4. Purulent nasal drainage (Acute Sinusitis)
  4. Mouth
    1. Tonsil hypertrophy (Non-allergic Rhinitis)
  5. Neck
    1. Cervical Lymphadenopathy (Infectious Rhinitis)
  6. Respiratory
    1. Wheezing (Asthma and Atopic Triad)
  7. Skin
    1. Eczema (Atopic Triad)

V. Diagnostics

  1. Eosinophils on nasal drainage evaluation
    1. Suggests Allergic Rhinitis or Eosinophilia Syndrome
  2. Allergy evaluation
    1. Skin Testing for allergy
    2. RadioAllergoSorbent Test (RAST)

VI. Differential Diagnosis

  1. Allergic Rhinitis
    1. Sneezing and Pruritus with seasonal variation
    2. Pale, boggy nasal mucosa
    3. Family History of Allergic Rhinitis or atopy
    4. Allergen exposure or positive Allergy Testing
  2. Non-allergic Rhinitis
    1. See Rhinitis Causes
    2. Perennial symptoms
    3. Post-nasal drainage
    4. Erythematous nasal mucosa
    5. Irritant exposure and negative Allergy Testing

Images: Related links to external sites (from Bing)

Related Studies

Ontology: Rhinitis (C0035455)

Definition (MSH) Inflammation of the NASAL MUCOSA, the mucous membrane lining the NASAL CAVITIES.
Definition (CHV) an inflammation of the nasal mucous membrane
Definition (MSHCZE) Rýma, zánět nosní sliznice. (cit. Velký lékařský slovník online, 2013 http://lekarske.slovniky.cz/ )
Definition (NCI) An inflammation of the mucous membrane lining the nose, usually associated with nasal discharge.
Definition (CSP) inflammation of the mucous membrane of the nose.
Concepts Disease or Syndrome (T047)
MSH D012220
SnomedCT 70076002
English Rhinitides, RHINITIS, rhinitis, rhinitis (diagnosis), Catarrh, Nasal, Nasal Catarrhs, Nasal Catarrh, Catarrhs, Nasal, Rhinitis NOS, Rhinitis [Disease/Finding], Inflammation of nasal passage, Rhinitis (disorder), Rhinitis, Rhinitis, NOS
French RHINITE, Rhinite SAI, Rhinite
Portuguese RINITE, Rinite NE, Catarro Nasal, Rinite
Spanish RINITIS, Rinitis NEOM, Catarro Nasal, rinitis (trastorno), rinitis, Rinitis
German RHINITIS, Rhinitis NNB, Rhinitis
Dutch rhinitis NAO, rhinitis, Rhinitis
Italian Rinite NAS, Catarro nasale, Rinite
Japanese 鼻炎NOS, ビエンNOS, ビエン, 鼻炎
Swedish Snuva
Czech rýma, rinitida, Rinitida NOS, Rinitida, rhinitis
Finnish Nuha
Croatian RINITIS
Polish Nieżyt nosa
Hungarian rhinitis k.m.n., rhinitis
Norwegian Rhinitt, Snue

Ontology: Acute Coryza (C0086066)

Concepts Finding (T033)
MSH D003139
English CORYZA, Acute Coryza, Coryza, nasal discharge coryza, coryza (physical finding), coryza, rhinitis acute, acute nasopharyngitis, acute rhinitis, acute coryza, Coryza, Acute
Dutch coryza, Coryza, acute
French Coryza, Rhinopharyngite aigüe, Coryza aigu, CORYZA, Rhinite aiguë épidémique, Rhinopharyngite aiguë
German Coryza, Coryza, akute, CORYZA
Italian Corizza, Coriza acuta
Portuguese Rinite, Coriza Aguda, CORIZA
Spanish Coriza, Coriza Aguda, CORIZA
Japanese 鼻感冒, ビカンボウ
Czech Koryza, koryza akutní
Hungarian Nátha
Norwegian Snue, akutt, Akutt snue

Ontology: Rhinorrhea (C1260880)

Definition (NCI) A discharge of fluid from the nose.
Concepts Sign or Symptom (T184)
SnomedCT 267101005, 397811005, 266377009, 6696001, 139651003, 206325007, 162381008, 155497009, 282041000009108, 64531003, 397746007
LNC LA21234-2, LA15890-9
English RHINORRHEA, RHINORRHOEA, Runny nose, Nasal discharge present (context-dependent category), Nasal discharge present (situation), nasal discharge rhinorrhea, rhinorrhea, rhinorrhea (physical finding), nasal discharge as symptom, nasal discharge (symptom), nasal discharge (physical finding), nasal discharge, Rhinorrhea, nose discharge, nose runny, nose run, Discharge;nasal, dripping nose, drips nose, nasal drip, discharge from nose, discharge nasal, Runny;nose, nose drip, nose running, runny nose, discharge nose, nasal catarrh, dripping nasal, drip nasal, drips nasal, nose runs, rhinorrhoea, running nose, Nasal Discharge, Runny Nose, Nasal discharge (& present) (finding), Nasal discharge present (finding), Rhinorrhea (finding), Nasal discharge (& present), Increased nasal secretion, Excessive noise from nasal passage, Snuffling (finding), Snuffling, Nose run, Nasal discharge, Snuffles, Nasal discharge present, Nose dripping, Nose running, Nasal discharge (disorder), Snuffles (finding), Rhinorrhoea, Discharge from nose, Nasal catarrh, catarrh; nasal, catarrh; nasopharyngeal, nasal; catarrh, nasopharyngeal; catarrh, snuffles
Italian Rinorrea, Secrezione nasale, Catarro nasale
Spanish secreción nasal presente (situación), Secreción nasal, Catarro nasal, Moqueo, secreción nasal presente (categoría dependiente del contexto), RINORREA, rinorrea (hallazgo), aumento de la secreción nasal, catarro nasal, resuellos (hallazgo), resuellos, rinorrea (trastorno), rinorrea, secreción nasal presente, secreción nasal, Rinorrea, descarga nasal
Dutch nasale afscheiding, loopneus, neusverkoudheid, catarre; nasofaryngeaal, catarre; neus, nasofaryngeaal; catarre, neus; catarre, rhinorroe
French Catarrhe nasal, Nez qui coule, Ecoulement nasal, RHINORRHEE, Rhinorrhée
German laufende Nase, Nasenkatarrh, Nasensekret, RHINORRHOE, Rhinorrhoe
Portuguese Corrimento nasal, Catarro nasal, Nariz com corrimento, RINORREIA, Rinorreia
Japanese 鼻漏, 鼻汁, 鼻カタル, ビジュウ, ハナジル, ビロウ, ハナカタル, ビカタル
Czech Příznaky rýmy, Rinorea, Nosní katar, Nosní sekrety
Hungarian Váladékozó orr, Rhinorrhoea, Catarrhus nasalis, Nasalis váladékozás