LYCOS RETRIEVER 
Rhinitis: Acute Rhinitis
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Viral URIs are the leading cause of acute rhinitis. Viruses known to cause acute viral rhinitis include rhinoviruses, respiratory syncytial virus, parainfluenza, influenza, and adenoviruses. In most patients, viral infections are self-limited and require only symptomatic treatment. Occasionally, a bacterial superinfection exists or the patient develops rhinosinusitis. In these patients, symptoms generally worsen (e.g., facial pain, nasal obstruction, fever). Sinusitis is best diagnosed through history, physical examination, and prediction rules, and not through computed tomography.
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Nasal inflammation associated with allergic rhinitis can ... cause obstruction of the sinus osteomeatal complex, thereby predisposing to bacterial infection of the sinuses. This process accounts for many cases of acute and chronic bacterial sinusitis. Symptoms of bacterial sinusitis may include nasal congestion, purulent rhinorrhea or postnasal drip, facial or dental pain, and cough. Purulent rhinorrhea, purulent postnasal drip, or pain in a maxillary tooth and persistent cough in children are the most useful predictors of bacterial sinusitis. However, no single symptom has a high degree of sensitivity or specificity in discriminating bacterial sinusitis from allergic or viral rhinitis [4,5].
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Allergic rhinitis, the most common type of rhinitis, generally can be differentiated from the numerous types of nonallergic rhinitis through a thorough history and physical examination. Allergic rhinitis may be seasonal, perennial, or occupational. The most common cause of nonallergic rhinitis is acute viral infection. Other types of nonallergic rhinitis include vasomotor, hormonal, drug-induced, structural, and occupational (irritant) rhinitis, as well as rhinitis medicamentosa and nonallergic rhinitis with eosinophilia syndrome. Since 1998, three large expert panels have made recommendations for the diagnosis of allergic and nonallergic rhinitis. Allergy testing (e.g., percutaneous skin testing, radioallergosorbent testing) is not necessary in all patients but may be useful in ambiguous or complicated cases.
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Topical corticosteroids are very effective in allergic rhinitis. They need to be used regularly as prophylactic agents and are not intended to relieve acute symptoms. Careful patient education is necessary to ensure correct usage of the drug. Once control of symptoms has been achieved the dosage should be reduced progressively to the minimum consistent with control of symptoms. Prolonged therapy may be required and they can be used long-term with safety.
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Depending on its etiology, nonallergic rhinitis may resemble allergic rhinitis in terms of rhinorrhea, sneezing, pruritus, and congestion. These symptoms may vary temporally, ranging from transient to nearly continuous. Inflammation in either type of rhinitis may induce an episode of acute rhinosinusitis in a patient predisposed because of blockages in functionally important intranasal passages.
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Bi Yan Pian works most effectively with acute rhinitis caused by the common cold or flu. It usually clears the nasal passages in 5 days.1 It takes longer for chronic rhinitis. In a study of 27 cases, 22 were found recovered and the other 5 improved.1
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Acute Rhinitis