Subacute rhinorrhea in a 42-year-old man

A Runny Nose: Rhinitis or Rhinorrhoea?

Rhinitis, whether allergic, infectious, or due to another aetiology, is an exceedingly common symptom in the population. Cerebrospinal fluid (CSF) rhinorrhoea occurs when there is a fistula between the dura and the skull base with discharge of CSF from the nose. Spontaneous CSF rhinorrhoea should be considered in the differential diagnosis of persistent nasal discharge called ‘runny nose’. We describe one case of CSF rhinorrhoea occurring in association with allergic rhinitis and sinusitis. A 46-year-old, obese female presented with a 1-week history of bilateral clear nasal discharge, undocumented fever, and postural headache. She described her nasal discharge as watery, and just like flows from the tap. A collected sample of her nasal discharge was tested for glucose and protein. CSF rhinorrhoea was considered as the primary diagnosis. Despite the whole work up, the origin of the CSF fistula could not be identified. She was discharged well for close follow up with no clinical sequelae. (Hong Kong j.emerg.med. 2016;23:57-60)

Spontaneous Rhinorrhea mimicking sinusitis

Spotaneous or non-traumatic cerebrospinal fluid rhinorrhea is an uncommon condition and may present a diagnostic challenge to clinicians. This condition is often being misdiagnosed for allergic rhintis or chronic sinusitis since the precipitating cause is not readily apperent in most patients. The mechanism of rhinorrhea is stil not completely clarified. We describe a case of this condition occuring in association with allergic rhinitis and sinusitis. A 52 year-old, obese female patient presented with two weeks history of bilateral clear nasal discharge and postural headache. Sample of nasal discharge tested for glucose and protein. The result was that the collection fluid was cerebrospinal fluid. The origin of cerebrospinal fluid fistula could not be identified despite the diagnostic tests.