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What Causes Unexplained Turbinate Inflammation?
Question: I've had nasal inflammation, especially my turbinates, for over 6 weeks. It started as apparent allergic rhinitis, likely due to ragweed and molds, which were high last month here in the U.S. Midwest. But as we've had our first hard freeze that's no longer a problem. I've had two ENTs endoscopic examinations of my nose and sinuses and no sign of infection from that. A CT scan was also normal. Is it possible that I could have low -grade staph infection that would not be detected except through a culture? No culture has been taken
Brief Answer:
Medication, nasal swab, turbinate reduction, desensitisation.
Detailed Answer:
Hi,
Thank you for your query.
1. It would be better if you upload CT and endoscopic images for reference.
2. I am assuming that the allergic rhinitis included symptoms such as sneezing, watery nasal discharge (rhinorrhea), nasal obstruction and allergic eye symptoms.
3. If there is no fever and sinus pain, this is best treated with anti-histamines (such as cetirizine/ fexofenadine) , anti-leukotrienes (such as fluticasone/ mometasone), steroid nasal sprays, steam inhalation and hypertonic saline nasal washes.
4. The suspicion of low grade staph infection is best settled by a nasal swab culture.
5. For persistent nasal turbinate hypertrophy not responding to 6-8 weeks of medical therapy, radio-frequency or coblation assisted nasal turbinate reduction is an effective option. Surface channeling can also reduce the allergy to the pollen and molds.
6. De-sensitisation to pollen and moulds can also be attempted.
I hope that I have answered your query. If you have any more questions I will be available to answer them.
Regards.
Medication, nasal swab, turbinate reduction, desensitisation.
Detailed Answer:
Hi,
Thank you for your query.
1. It would be better if you upload CT and endoscopic images for reference.
2. I am assuming that the allergic rhinitis included symptoms such as sneezing, watery nasal discharge (rhinorrhea), nasal obstruction and allergic eye symptoms.
3. If there is no fever and sinus pain, this is best treated with anti-histamines (such as cetirizine/ fexofenadine) , anti-leukotrienes (such as fluticasone/ mometasone), steroid nasal sprays, steam inhalation and hypertonic saline nasal washes.
4. The suspicion of low grade staph infection is best settled by a nasal swab culture.
5. For persistent nasal turbinate hypertrophy not responding to 6-8 weeks of medical therapy, radio-frequency or coblation assisted nasal turbinate reduction is an effective option. Surface channeling can also reduce the allergy to the pollen and molds.
6. De-sensitisation to pollen and moulds can also be attempted.
I hope that I have answered your query. If you have any more questions I will be available to answer them.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I'm sorry -- but you didn't answer my question.
My question was very simple: Is it possible for a low-grade staph infection
in the nose to be undetected by an endoscopy and CT scan? Could it be missed by a doctor without a culture?
I've had two endoscopies and a CT scan and there was no evidence of
infection.
But again, is it possible for the endoscopy and CT scan to be normal
and for someone to still have a staph infection?
You never answered my question.
My question was very simple: Is it possible for a low-grade staph infection
in the nose to be undetected by an endoscopy and CT scan? Could it be missed by a doctor without a culture?
I've had two endoscopies and a CT scan and there was no evidence of
infection.
But again, is it possible for the endoscopy and CT scan to be normal
and for someone to still have a staph infection?
You never answered my question.
Brief Answer:
Yes, a sub clinical infection is possible.
Detailed Answer:
Hi,
Thank you for writing back.
1. Yes, a low grade subclinical staph infection is possible.
2. In fact a carrier state is a known problem with staph, though it is not very common. In such cases, there are minimal or no signs or symptoms.
3. This means that unless you get a nasal and throat swab done, you will not be able to settle this suspicion.
4. In hospitals, a deep nasal and a throat swab is used for surveillance among patients, relatives and caregivers as there is no other way to assess these carrier states.
5 Of special significance is the detection of MRSA (Methicillin Resistant Staph Aureus), VRSA (Vancomycin Resistant Staph Aureus) where stronger antibiotics are used. These resistant types of staph are more likely to cause signs and symptoms.
I hope that I have answered your query. If you have any more questions I will be available to answer them.
Regards.
Yes, a sub clinical infection is possible.
Detailed Answer:
Hi,
Thank you for writing back.
1. Yes, a low grade subclinical staph infection is possible.
2. In fact a carrier state is a known problem with staph, though it is not very common. In such cases, there are minimal or no signs or symptoms.
3. This means that unless you get a nasal and throat swab done, you will not be able to settle this suspicion.
4. In hospitals, a deep nasal and a throat swab is used for surveillance among patients, relatives and caregivers as there is no other way to assess these carrier states.
5 Of special significance is the detection of MRSA (Methicillin Resistant Staph Aureus), VRSA (Vancomycin Resistant Staph Aureus) where stronger antibiotics are used. These resistant types of staph are more likely to cause signs and symptoms.
I hope that I have answered your query. If you have any more questions I will be available to answer them.
Regards.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Thank you.
Brief Answer:
Repeat swabs and PCR.
Detailed Answer:
Hi,
Thank you for writing back.
1. Remember that a single negative swab does not rule out a staph carrier. Get a PCR (polymerase chain reaction) test done in addition.
2. Upload all the test results if you need any further clarification.
Wishing you a speedy recovery and good health.
Regards.
Repeat swabs and PCR.
Detailed Answer:
Hi,
Thank you for writing back.
1. Remember that a single negative swab does not rule out a staph carrier. Get a PCR (polymerase chain reaction) test done in addition.
2. Upload all the test results if you need any further clarification.
Wishing you a speedy recovery and good health.
Regards.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
thank you
Brief Answer:
Thank You.
Detailed Answer:
Thank You.
Thank You.
Detailed Answer:
Thank You.
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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