Which 3 viruses are the major cause of infectious rhinitis?
The upper airways (i.e., nose, nasopharynx and sinuses) are lined by what type of epithelium?
Allergic rhinitis is an example of what type of hypersensitivity rxn?
Type 1 - immediate
Which 2 bacteria are most likely to be superimposed on infectious rhinitis?
- S. pneumoniae
- H. influenzae
How does the nasal discharge differ grossly if rhinitis purely viral or has a superimposed bacterial infection?
- Viral will have clear nasal discharge
- Bacteria will cause thick, purulent, sometimes suppurative discharge
Rhinitis/sinusitis characterized by marked mucosal edema, redness, and mucus secretion accompanied by a leukocytic infiltrate with prominent eosinophils describes what?
Edematous nasal mucosa w/ loose stroma, often harboring hyperplastic or cystic mucous glands w/ a variety of infiltrates including neutrophils, eosinophils, plasma cells, and occasional cluster of lymphocytes is characteristic of what?
What is the cause of nasal polyps?
Recurrent attacks of rhinitis
Maxillary sinusitis occasionally arises from extension of an infection from where?
Periapical infection through bony floor of the sinus (oral flora)
Obstruction and impairment of sinus drainage in sinusitis may lead to what 2 gross findings?
- Empyema = impounded suppurative exudate
- Mucocele = accumulation of mucus secretions
Which patients are at higher risk for particularly severe forms of chronic sinusitis and by which type of organisms?
- Fungi (i.e., Mucormycosis)
Kartagener Syndrome is characterized by what triad and the sx's are all caused by what?
- Situs inversus
- Sinusitis (less common)
- All sx's due to defective ciliary action
What are 2 possible complications which may arise due to spread of infection associated with chronic sinusitis?
- Speading into the orbit or penetrating surrounding bone --> osteomyelitis
- Spreading into cranial vault --> septic thrombophlebitis of a dural venous sinus
What are 3 frequent complications which may arise from chronic sinusitis of the ethmoid sinus?
- Preseptal cellulitis
- Orbital cellulitis
- Subperiosteal abscess
What are 3 conditions which can produce necrotizing ulcerating lesions of the nose and upper respiratory tract?
- Acute fungal infections (i.e., Mucormycosis)
- Granulomatosis w/ polyangiitis (Wegener)
- Extranodal NK/T-cell lymphoma, nasal-type
Which sex, ethnicities, and age group is most frequently affected by extranodal NK/T-cell lymphomas?
- Males in the 5th-6th decade
- Most common in those of Asian or Latin American descent
Extranodal NK/T-cell lymphomas are related to which virus?
What are 3 systemic signs/sx's related to lymphomas?
- Night sweats
- Weight loss
Acute invasive sinusitis requires what prompt treatment?
Emergent IV antifungal therapy to prevent extension into brain or sepsis
Which bacteria are most commonly found superimposed on pharyngitis/tonsilitis of viral origin?
- β-hemolytic strep = most common
- S. aureus
How are the hyphae formed by Mucormycetes distinct from Aspergillus hyphae?
Form nonseptate hyphae of variable width w/ frequent right-angle branching
Involvement of which other organ system may develop in pt with rhinocerebral mucormycosis and what is seen?
- Lesions of combined hemorrhagic pneumonia w/ vascular thrombi and distal infarctions
Which sinus is most often involved in obstruction of outflow in sinusitis leading to a mucocele?
Proliferating masses of hyphae due to Aspergillus frequently form what?
"Fungus balls" = mycetoma
Describe the presentation of granulomatosis with polyangiitis in the sinus tract.
- Necrotizing granulomas of the upper or lower respiratory tract or both
- Necrotizing or granulomatous vasculitis affecting small-to-medium sized vessels
- Can lead to ulceration, necrosis, or perforation of the septum
Enlarged, reddened tonsils (due to reactive lymphoid hyperplasia) dotted by pinpoints of exudate emanting from tonsillar crypts is known as what?
Nasopharyngeal angiofibroma is a benign tumor found almost exclusively in whom?
Also associated with what GI disorder?
- Adolescent males who are most often fair-skinned and red headed
- Association w/ FAP
Nasopharyngeal angiofibroma arises from which layer of tissue and in which location?
Fibrovascular stroma of the posterolateral wall of the ROOF of the nasal cavity
What is the treatment of choice for nasopharyngeal angiofibroma?
Sinonasal (Schneiderian) Papilloma most often occurs in which sex and age group?
Adult males between the ages 30-60 yo