Allergic rhinitis masks: Nasal polyposis in two preschool children

Abstract

Nasal symptoms such as nasal congestion, rhinorrhea, and cough are especially common in children. Despite symptomatic treatment (various nasal sprays, physiotherapy, antibiotics and topical glucocorticosteroids), nasal congestion can persist for a long time. In such cases, several diseases are most likely: adenoids, allergic rhinitis, various anomalies in the structure of intranasal structures and sinuses (for example, curvature of the nasal septum), rhinosinusitis (acute, subacute). If a child has two main symptoms ― congestion and discharge from the nose ― and such additional symptoms as a headache with predominant localization in the paranasal sinuses and a deterioration in smell (possibly also the taste of food) for more than 3 months, it is necessary to exclude the diagnosis of chronic rhinosinusitis, which can be combined with a nasal polyp. The purpose of this article is to analyze clinical cases of chronic rhinosinusitis with nasal polyp in two preschool children, including one of them with intolerance to non-steroidal anti-inflammatory drugs, and to raise physicians' awareness of this nosology. In children with symptoms such as prolonged nasal congestion, rhinorrhea, possibly impaired sense of smell, headache, intolerance to non-steroidal anti-inflammatory drugs, in the absence of sensitization and immunodeficiency, a computed tomography scan of the paranasal sinuses is recommended to exclude nasal polyp.