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Suggest Treatment For Inflammation And Allergic Rhinitis Due To Mold
Question: Please read this carefully. Thank you. I may have contacted you before -- but I have a different question.
I have had turbinate inflammation since the beginning of October -- 7 weeks.
It came on suddenly. I have allergies -- and have been getting shots for 5 years -- but the
allergist and ENT deduced that the cause of the rhinitis was probably my exposure to certain outdoor molds
that were high here in the Midwest. However, we've had our first freeze and the molds should have been killed off. But my inflammation continues, though it's somewhat better than it was at the beginning.
I have some anatomical issues too -- a moderately deviated septum and a collapsed nasal valve.
I've seen two ENTs and they've done endoscopic scopes, including one last week, and a CT scan (in October) but have found no sign of infection. The endoscopies and CT scan found no evidence of bacterial or fungal infection.
They have suggested surgery.
Before I decide on that step, I want to be certain that I don't have an undetected bacterial infection.
Is it possible that someone such as me could still have a bacterial infection that is causing the swollen turbinates, yet it not be seen on the CT scan or endoscopy? And if so, is it a very rare possibility or something more possible. And if so, what should I do?
I have had turbinate inflammation since the beginning of October -- 7 weeks.
It came on suddenly. I have allergies -- and have been getting shots for 5 years -- but the
allergist and ENT deduced that the cause of the rhinitis was probably my exposure to certain outdoor molds
that were high here in the Midwest. However, we've had our first freeze and the molds should have been killed off. But my inflammation continues, though it's somewhat better than it was at the beginning.
I have some anatomical issues too -- a moderately deviated septum and a collapsed nasal valve.
I've seen two ENTs and they've done endoscopic scopes, including one last week, and a CT scan (in October) but have found no sign of infection. The endoscopies and CT scan found no evidence of bacterial or fungal infection.
They have suggested surgery.
Before I decide on that step, I want to be certain that I don't have an undetected bacterial infection.
Is it possible that someone such as me could still have a bacterial infection that is causing the swollen turbinates, yet it not be seen on the CT scan or endoscopy? And if so, is it a very rare possibility or something more possible. And if so, what should I do?
Brief Answer:
Yes, presence of microbes or fungus can induce chronic sinusitis...
Detailed Answer:
Hi
Thanks for posting the query
I have gone through your query and understood your problem thoroughly; I will try my best to help you with this.
Yes, chronic rhino-sinusitis can harbor bacteria such as staphalococci and pseudomonas and sometimes fungus. But this is very unusual to cause gross hypertrophy of the turbinates. The former and the later are usually associated with constant discharge from the nose, followed by nasal block and headache.
The presence of microbes can be identified by nasal swab culture. The hypertrophied turbinates is the hallmark of allergic nasal condition and vasomotor rhinitis.
Finally, there could be some unidentified allergens in the atmosphere which could be triggering the attacks of allergy. Hence, you would require continuing the medicines for allergy and undergo turbinoplasty, if the nasal block is persisting.
Hope this answers your query; I will be available for the follow-up queries.
Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Yes, presence of microbes or fungus can induce chronic sinusitis...
Detailed Answer:
Hi
Thanks for posting the query
I have gone through your query and understood your problem thoroughly; I will try my best to help you with this.
Yes, chronic rhino-sinusitis can harbor bacteria such as staphalococci and pseudomonas and sometimes fungus. But this is very unusual to cause gross hypertrophy of the turbinates. The former and the later are usually associated with constant discharge from the nose, followed by nasal block and headache.
The presence of microbes can be identified by nasal swab culture. The hypertrophied turbinates is the hallmark of allergic nasal condition and vasomotor rhinitis.
Finally, there could be some unidentified allergens in the atmosphere which could be triggering the attacks of allergy. Hence, you would require continuing the medicines for allergy and undergo turbinoplasty, if the nasal block is persisting.
Hope this answers your query; I will be available for the follow-up queries.
Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by :
Dr. Sonia Raina
Actually you did not answer a key part of my question. I know that microbes and fungus
can induce sinusitis.
But my question was: Is it possible that someone such as me could still have a bacterial infection -- yet it not be seen on the CT scan or endoscopy? And if so, is it a very rare possibility or something more possible.
I do have discharge from the nose but it is white and pale yellow.
can induce sinusitis.
But my question was: Is it possible that someone such as me could still have a bacterial infection -- yet it not be seen on the CT scan or endoscopy? And if so, is it a very rare possibility or something more possible.
I do have discharge from the nose but it is white and pale yellow.
Brief Answer:
Bacterial infection is very unlikely to be missed either in CTscan or scopy
Detailed Answer:
Hi
Thanks for writing back
1. Bacterial infection is identified by the presence of purulent discharge pouring out from the sinuses, whereas that of fungus is a dark colored mucin. Both of these conditions can be easily identified by nasal endoscopy and sometimes in the CT scan (presence of fluid level in case of bacterial infection and Charcot Leyden crystals in allergic fungal sinusitis).
According to your scan and nasal endoscopy, there is no evidence of any infection. Hence, in your case it is very unlikely to be a bacterial infection. If the doctor wants to confirm the same, a nasal swab would be definitely helpful.
2. Pale yellowish or whitish discharge can also be seen in allergic rhinitis and viral rhinitis and it is not necessarily a sign of bacterial infection.
Hope this clarifies your doubts. Wish you good health.
Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Bacterial infection is very unlikely to be missed either in CTscan or scopy
Detailed Answer:
Hi
Thanks for writing back
1. Bacterial infection is identified by the presence of purulent discharge pouring out from the sinuses, whereas that of fungus is a dark colored mucin. Both of these conditions can be easily identified by nasal endoscopy and sometimes in the CT scan (presence of fluid level in case of bacterial infection and Charcot Leyden crystals in allergic fungal sinusitis).
According to your scan and nasal endoscopy, there is no evidence of any infection. Hence, in your case it is very unlikely to be a bacterial infection. If the doctor wants to confirm the same, a nasal swab would be definitely helpful.
2. Pale yellowish or whitish discharge can also be seen in allergic rhinitis and viral rhinitis and it is not necessarily a sign of bacterial infection.
Hope this clarifies your doubts. Wish you good health.
Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Answered by
Dr. Naveen Kumar Nanjasetty
Otolaryngologist / ENT Specialist
Practicing since :2001
Answered : 2544 Questions
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