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Having brownish and dark nasal discharge. Sinus infection or CSF leakage?

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General & Family Physician
Practicing since : 2001
Answered : 11953 Questions
Hello, I am worried I may have a CSF Leak. I have taken a picture of a hankerchief with the possible 'stains' of it, as it only drops out when I completely tilt my head down, and apply pressure.

Notes - I have not had any head injuries. It has been happening for about 2 years, and this NEVER happens when I sit upright or even tilt my head by the slightest. I am worried it could be a sinus infection of some sort, as it only happens to one of my nostrils, that I (embarrassingly) tend to pick the most.
I was informed that CSF is a clear, liquid. However, as you can see, this is brownish and dark. I also pick my nose a lot, especially the right nostril, so I hope it is just an infection of some sort in the nose.
Please also let me know the possibility of Nasal Discharge, as it only happens to my right Nostril.
Posted Wed, 9 Jan 2013 in Brain and Spine
Answered by Dr. Michelle Gibson James 4 hours later
Hi, thanks for using healthcare magic

It is unlikely to be a CSF leak- this would not occur over such a prolonged time period.In addition it would be associated with a severe headache, dizziness, loss of balance, tiredness, blurred vision.
As you correctly stated, it is more likely to be an infection of the right nostril or in some cases of minute trauma (picking of the nose) to an area, you can have dried blood mixed up with nasal secretions. The dried blood would result in a brown discolouration.
To treat you would need to eliminate the trauma to the nostril, observe whether after 3 to 4 days of no picking of the nostril, the secretions are reduced.
If they remain at the same level then you may want to consider visiting your doctor to determine, by examination, whether an infection is present.

Hope this helps , feel free to ask any questions
Above answer was peer-reviewed by
Follow-up: Having brownish and dark nasal discharge. Sinus infection or CSF leakage? 8 minutes later
Thank you Doctor for your response - I guess the feared the worst!

What would be the best treatment for this infection in my right nostril? As it has been happening for over a few years, why was this infection not able to recover in itself, would it come down to my regular 'bad habits' that irritate it? I suppose I should stop this habit of mine.

Also, why is it that the fluid only feels runny when I tilt my head down? Many thanks.
Answered by Dr. Michelle Gibson James 9 minutes later
Hi, you had stated that you commonly would pick your right nostril. Once there is repeated trauma to any area of the body then it would be difficult for the area to heal.
Any habit is difficult to break, they become part of a routine, but if possible you need to stop to allow healing to occur, it would not do it otherwise.
When you feel the urge to do it, replace it with another activity instead.

A topical antibiotic cream would be appropriate if thought neccessary by your doctor.
When you tilt your head down, by gravity, the fluid would more likely run down, it would be easier for it to flow out.

Feel free to ask anything else
Above answer was peer-reviewed by
Follow-up: Having brownish and dark nasal discharge. Sinus infection or CSF leakage? 7 minutes later
Thank you again Doctor.

So ontop of stopping this bad habit of mine, do you think any specific foods/diets (to supplement the treatment) might help in allowing the right nostril to heal? I do think that I don't drink enough water.
Answered by Dr. Michelle Gibson James 1 hour later
There are no specific foods that may augment the healing process just a generally healthy diet.
Try and eat a variety of different fruits and vegetables- that way you would be more likely to obtain most of the vitamins and minerals as different produce contain different vitamins.
Try, if possible, to use at least 5 servings of fruits and vegetables and increase your water intake to at least 8 glasses a day.Reduce your consumption of fruit juices and sodas because these contain fructose which if taken in excess can have detrimental effects on the body

If anything remains unclear, feel free to ask anything else
Above answer was peer-reviewed by
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