Rhinitis, Allergic/Allergic Rhinosinusitis
Rhinitis, allergic/allergic rhinosinositis
General and supportive measures
ICD-10 code: J30.4
DESCRIPTION
Recurrent inflammation of the nasal mucosa due to hypersensitivity to inhaled allergens. May present with a running, itchy nose and eyes, and excessive sneezing (“runner”) and/or with nasal obstruction (“blocker”). Look for salute sign and allergic "shiners". Recurrent symptoms or lasting longer than 14 days. This diagnosis is unusual in patients under 2 years of age; similar symptoms in this age group are most likely due to the common cold.
GENERAL AND SUPPORTIVE MEASURES
- Avoid allergens and irritants.
- Consider other allergic conditions such as asthma and allergic conjunctivitis, see Primary Healthcare Standard Treatment Guidelines and Essential Medicines List: Eye Conditions, Conjunctivitis, Allergic.
MEDICINE TREATMENT
For patients whose symptoms affect their quality of life:
- Corticosteroid aqueous nasal solution, e.g.:
- Fluticasone, 50 µg, 1 spray into each nostril daily. (Children > 12 years old, 2 sprays in each nostril daily.)
During periods of exacerbation of symptoms, a short course of non-sedating antihistamine can help, e.g.:
- Cetirizine, oral, as a single dose at night if the predominant symptoms are sneezing, nasal itching and rhinorrhoea:
- Children 3–12 years: 5 mg.
- Children older than 12 years: 10 mg.
Standard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Paediatrics, 2023 Edition
Chapter 17: Ear Nose & Throat, 17.10 Rhinitis, Allergic/Allergic Rhinosinusitis