Smelly nasal discharge

Introduction Nasal purulent odor is one of the clinical manifestations of chronic suppurative sinusitis. Chronic purulent sinusitis is a chronic suppurative inflammation of the sinus mucosa.

Cause

Most of the causes of acute suppurative sinusitis have not been timely and rational treatment delay. Other causes are similar to acute suppurative sinusitis, and infection, allergic rhinitis, and sinus drainage are the main causes.

More common in acute cases, among which chronic maxillary sinusitis is the most common, often combined with chronic ethmoid sinusitis, such as one or both sides of the sinus have lesions, called polysinusitis (polysinusitis) or total sinusitis (pansinusits), Chronic ethmoid sinusitis or sphenoid sinusitis alone accounts for a small number of cases.

an examination

Related inspection

Otolaryngology CT examination nasal endoscopy

1. Nasal examination: The lesions are mainly changed in the upper part of the nasal cavity, and the middle turbinate edema or hypertrophy and polypoid changes can be seen. Some have multiple polyps. In the anterior group of sinusitis, there may be adhesions of mucopurulent secretions on the surface of the middle nasal passage and the inferior turbinate. In the posterior group, sinusitis can be seen in the olfactory sulcus and in the posterior part of the middle nasal passage.

2. Position drainage: suspected chronic suppurative sinusitis and no pus in the middle nasal passage or olfactory sulcus, feasible position drainage examination.

3. Maxillary sinus puncture washing: maxillary sinus puncture washing is not only a diagnostic method for maxillary sinusitis, but also a treatment. The effluent should be used for aerobic bacterial culture.

4. X-ray sinus film: for patients with unclear diagnosis or suspected other lesions, can help diagnose.

5. Examination of the teeth: In the case of suspected odontogenic maxillary sinusitis, the relevant teeth should be examined.

Differential diagnosis

Mucopious nasal sputum: In the late stage of acute rhinitis, the nasal sputum turns from a watery sample to a mucous sputum. In the recovery period, the mucous epithelial cells and multinucleated white blood cells mixed with destruction in the mucus sputum become a purulent sinus.

Watery nose: a mixture of vascular spills and mucus containing a small number of red blood cells, exfoliated cells, bacteria and mucin. More common in the early stages of acute rhinitis that is the beginning of a cold. Allergic rhinitis encounters allergic substances, it will immediately flow out of the watery nose, accompanied by continuous sneezing; away from allergens, it will immediately improve.

Mucous nasal discharge: The liquid secreted by the nasal cavity under normal conditions is mucoid. However, under normal circumstances, it does not take the initiative to flow out. If there are more mucous nasal discharges, it is often seen in emotional changes such as excessive surprise, sadness, and crying. In addition, when the nasal cavity is exposed to certain physical stimuli or inflammation, it will also make mucus. Sexual snoring increases and flows out.

Purulent snoring: common in chronic sinusitis lasting for a long time, when the range of inflammatory erosion is large. Acute maxillary sinusitis, a yellow purulent nasal discharge, severe chronic maxillary sinusitis, may be a pussy purulent nasal discharge and odor. After a long time in children's nasal foreign body, there is a purulent nasal discharge and smell.

Bloody nose: If parents find that their child's nose is often mixed with blood, or is itself a bloody nose, especially chronic or intermittent long-term bloody nose, it should be taken seriously. This is more common in acute rhinitis, atrophic rhinitis, nasal stones, nasal granuloma, nasal foreign bodies, ulcers and malignant tumors. If the bloody nose often flows back and is spit out through the mouth, it is often an early symptom of nasopharyngeal cancer. It should be vigilant and go to the hospital as soon as possible.

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