Discussions By Condition: I cannot get a diagnosis.

Sinus symptoms, cuts inside nose, for over a year?!

Posted In: I cannot get a diagnosis. 2 Replies
  • Posted By: Anonymous
  • June 3, 2009
  • 09:10 PM

my boyfriend has had chronic sinus problems since i met him, it's been on and off for over a year. The doctors keep putting him on antibiotics, steroids, OTC sinus and nasal medications, etc. These things make the situation temporarily better, but it always comes back. His chest X-rays were fine, he's been using saline nasal wash and things like neosporin on the cuts inside his nose, and he smokes abut a pack a day. He eats well and takes vitamins. He is constantly in pain and blowing his nose. I've said it could be chronic sinus infection and the smoking isn't helping, but now with the sores inside the nose, it seems to be getting worse. He says he's had maybe two weeks of relief from it in the past year and a half.

Here are the symptoms:
constant stuffed nose - one nostril always blocked
gashes, open sores, cuts inside the nose that don't seem to heal
mild wet cough
sinus pressure

your help is appreciated!

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2 Replies:

  • If u consider it to be more than an upsetting ENT problem, especially if there are other signs and symptoms that you might have left out, and if there are no local reasons for such a severe chronic sinusitis, u should take your boyfriend to a rheumatologist. He will perform some blood test (CBC, inflammation tests, and immunological tests --> cANCA and maybe the other ANCAs and ANA if he thinks is necessary), and he will probably perform a nasal byopsy (looking for signs of vasculitis and/or granuloma). Also he will look for kidney or pulmonary problems... and of course for ocular, neurological or any other problems. If he finds it necessary he can also perform a blind (meaning that there is no obvious disease at this site) temporal artery biposy (this beeing a good place to look for vasculitides) but I doubt that he would use this pretty invasive procedure for a disease that seems to afect no other organs. If the cANCA are positive or the byopsy is sugestive and there are no other organs involved (wich I presume are not since it would show up on rutine blood test and pulmonary x-rays) then the diagnosis is localized Wegener disease. This is a rare disease, and serious if the kidneys and lungs are involved, but higly treateble even in severe forms. The localised forms are easily treated and normally respond promptly and well to treatment.
    Lauritka 7 Replies Flag this Response
  • Could it be cartarhh?http://en.wikipedia.org/wiki/CatarrhOr phlegm?but the way that chinese medicine practitioners view phlegm not the way standard doctors do
    Anonymous 42789 Replies Flag this Response
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