Friday, June 15, 2012

Rhinosinusitis Aetiology

Rhinosinusitis  may be caused by very different factors that may be grouped into two major blocks:
A. Non-allergic rhinosinusitis
Through nonspecific infections, mostly viral, such as the common cold or catarrh, but also bacterial, mixed origin (virus and bacteria), and finally and rarely, fungal.



The main viruses involved are Rhinovirus, Myxovirus, Coronavirus and Adenovirus, and the bacterias that usually superinfect after the virus include Haemophilus influenza and Klebsiella pneumoniae.
In response to vasomotor or irritative factors, triggered by the following aspects: occupational, emotional, environmental, endocrine and medicinal products.
Dental factors particularly due to irregularly positioned teeth (ectopies).
Traumatic or trophic factors that entail the presence of foreign bodies in the mucosa.
B. Allergic rhinosinusitis (Hay fever)
Episodes in which there is an inflammation caused by immunoglobulin E. (IgE) following exposure to an allergen that acts as a trigger for the process. The following typologies are clearly identified:
Seasonal allergic rhinitis, caused by pollens from grass, bushes and trees. The symptoms used to be limited to the pollenisation seasons such as spring and summer. However, due to climate changes and cross reactions in many individuals, episodes are observed throughout the year.
Perennial allergic rhinitis, caused by dust mites and/or animal hairs and feathers. It gives rise to ‘bouts’ throughout the year.
Food and occupational allergic rhinitis, which is caused by intake or inhalation of substances such as latex, flour or seafood.
Talking to the patient in Pharmaceutical Care will help to ascertain and understand the origin of the disease, family history, triggers and previous treatments and responses to them.
The patient will usually require an examination of the nose, eyes, ears and lungs. Complementary tests, particularly for allergies and imaging exams (endoscopy, scanner) to determine the origin and extent of the disease are also common. The patient should be referred to a doctor for these exams. Communication with the patient in Pharmaceutical Care will provide information about the patient's symptoms, the origin of his/her illness, family history, outstanding causes as well as previous and subsequent treatments, which will then affect how we provide pharmaceutical indication consultation.

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