Allergic rhinitis: case study

Ciara is a ten-year-old girl. 'She has had one cold after another for the past two years,' her mother said. I asked her what she meant by that. 'She is always getting sore throats and sore ears, she sniffs all the time, and she can't breathe through her nose,' she explained. The child was the portrait of misery. 'And look!' she continued, pointing to the girl's upper lip, 'She has the skin of her face rubbed raw with tissues.’ It did not take long to hazard a guess at the problem: the lining inside Ciara's nose was inflamed. It looked an angry blood-red. There was also a copious nasal discharge of clear mucus, like raw egg white. Her turbinates were swollen to the point of obstructing both nostrils. She was breathing through her mouth. In addition, one ear was full of fluid, as could be seen through a lacklustre eardrum. Skin tests revealed that Ciara was highly allergic to house dust mites, grass pollen and some moulds. Ciara has, until proven otherwise, an allergic rhinitis.

Let's take a closer look at Ciara's symptoms. The inflammation in her nose was causing rhinorrhoea and obstruction. The obstruction was blocking one of her Eustachian tubes, allowing an accumulation of fluid in the middle ear on that side. The resultant pressure in her ear was painful. Nasal obstruction was also causing her to breathe through her mouth, and this was drying her throat excessively, particularly during sleep. It was no wonder she had sore throats. Furthermore, because she couldn't breathe easily, her sleep was bound to be disrupted, contributing to her tiredness and misery.



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