History of chronic “runny nose” and “no medications are hjelping”. The patient has been on Apoquel. The patient is having apparent asthma attacks, intermitently, up to 2-3 per day.
History of chronic “runny nose” and “no medications are hjelping”. The patient has been on Apoquel. The patient is having apparent asthma attacks, intermitently, up to 2-3 per day.
CT of the head, plain and post contrast series – There was moderate right-sided, mild left-sided even swelling of the mucosal lining of the nasal concha within the mid third of both nasal cavities. The right nasal cavity presented moderate turbinate destruction. There was a moderate amount of fluid material accumulating on the floor within the mid-portion of the right nasal cavity and within the caudal aspect of the right dorsal nasal concha. The nasal septum was deviated to the left side.
The submandibular lymph nodes were within normal limits regarding size, shape, attenuation and contrast enhancement. The medial retropharyngeal lymph nodes were not included in the scan.
A chronic infectious – such as bacterial or viral/parasitic with superinfection – cause is most likely. There were no signs specific for fungal rhinitis. However, an early stage of a fungal rhinitis – such as Aspergillosis – is a potential too.
A foreign body associated rhinitis with focal conchal destruction is less likely.
There was no evidence of nasal neoplasia.
For further workup rhinoscopy is recommended. Samples for bacterial and fungal cultures should be obtained.
