BT an 8 year old boy was presented for check-up after developing nasal congestion, sneezing and coughing. According to her mother, the boy has been developing these symptoms regularly after play or when the house is being dusted. A differential diagnosis pointed to a huge possibility of allergic rhinitis or common cold. Nonetheless, based on subjective assessment and physical examination, common cold was ruled out since the patient was afebrile, hence ruling out the possibility of an infection. As such, the primary diagnosis for this patient was allergic rhinitis and according to Greiner et al. (2012), allergic rhinitis or hay fever is pretty common in children due to their comparatively high probability of coming into contact with triggers or allergens such as pollen grains, animal dander or dust during play. An allergy blood test (radioallergosorbent test) for the patient showed the existence of an allergic reaction to dust and this is something consistent with allergic rhinitis.
As Hockenberyy & Wilson (2014) asserts, pediatric assessment is appreciably complex and requires a unique approach, notably, relying on the parent, guardian or a surrogate member who has a vivid understanding of the child’s health history and environment. BT’s mother was cooperative and showed a high level of understanding of the child and this was a major boost to this patient assessment.
The treatment for the patient involved the use of nasal corticosteroids (a nasal spray) to help in relieving symptoms such as runny nose, nasal itching and nasal inflammation caused by the fever (Rondón et al., 2012). Essentially, allergic rhinitis is triggered by environmental factors and patient teaching on how to about environmental modification was necessary as a preventive measure (Rondón et al., 2012). In this regard, I educated BT’s mother on the importance of environmental modification including monitoring the child’s home and school environments for triggers such as pollen grains, animal dander and dust.
One of the intriguing aspects of this patient experience is how ear, nose and throat conditions may pose confusing features which are rather similar. For instance, from the superficial analysis of this case, one could possibly rule in the possibility of common cold which could lead to a misdiagnosis. There was indubitable agreement between class room teachings on ENT disorders and this patient scenario, especially on the role of the environment in the pathophysiology of many ENT conditions. There is thus an accentuation to factor in the effect of the environment when assessing and consequently managing ENT conditions.
References
Greiner, A. N., Hellings, P. W., Rotiroti, G., & Scadding, G. K. (2012). Allergic rhinitis. The Lancet, 378(9809), 2112-2122.
Hockenberry, M. J., & Wilson, D. (2014). Wong's nursing care of infants and children. Elsevier Health Sciences.
Rondón, C., Campo, P., Togias, A., Fokkens, W. J., Durham, S. R., Powe, D. G., & Blanca, M. (2012). Local allergic rhinitis: concept, pathophysiology, and management. Journal of Allergy and Clinical Immunology, 129(6), 1460-1467.
