Establish reason why purulent rhinitis is persistent first

doi:10.1136/bmj.326.7387.502/a

BMJ 2003;326:502 ( 1 March )

Letters

Establish reason why purulent rhinitis is persistent first

The first 150 words of the full text of this article appear below.

EDITOR $---$ The editorial by Arroll and Kenealy was a helpful and interesting summary of the role of systemic antibiotic treatmentin managing acute purulent rhinitis.¹ The authors define thecondition as persisting for up to 10-14 days before treatmentmay be indicated. Starting treatment at this time is, however,to be discouraged without a diagnosis. This is particularly truewhen the rhinitis is unilateral orbloodstained.

Persisting unilateral purulent rhinitis in a child may be caused by a nasal foreign body requiring removal.² If the dischargeis bilateral and recurrent over a long time the resulting adnenoiditisand nasal obstruction may warrant consideration ofadenoidectomy.

In adults neoplasia is a diagnosis of exclusion if purulent rhinitis persists, particularly if it is unilateral and bloodstained.³

The article does not offer important axiomatic information to non-specialists, who may be asked to offer an opinion on sucha symptom fairly often. If purulent . . . [Full text of this article]