HISTORY OF PRESENTING

ILLNESS
NASAL BLEED 2 YRS

ON AND OFF
ASSC. WITH FORCIBLE NASAL BLOW
LAST EPISODE YESTERDAY MORNING(19/1/2016)
SCANTY AMOUNT

RECURRENT RESPIRATORY TRACT INFECTION 2 TO 3 EPISODES EACH MONTH

 H/O NASAL OBSTRUCTION-BILATERAL,GRADUAL

ONSET,PROGRESSIVE IN NATURE,CONTINOUS,AGGRAVATED
WITH EPISODES OF URTI AND RELIEVED WITH NASAL
DECONGESTANTS FOR PAST TWO YEARS
H/O NASAL DISCHARGE BILATERAL,ONLY DURING TIMES OF
URTI ,WHICH IS MUCOPURULENT,NOT ASSOCIATED WITH
ODOUR.
NO H/O SNEEZING BOUTS
NO H/O NASAL SWELLING

 NO H/O NASAL PAIN

NO H/O HEADACHE
NO H/O TRAUMA TO NOSE
NO H/O DEFECTIVE VISION
NO H/O EPIPHORA
NO H/O BLOCKED SENSATION OF EAR/EAR ACHE
NO H/O EAR DISCHARGE
NO H/O TRISMUS/DIFFICULTY IN CHEWING
NO H/O DYSPHAGIA

 NO H/O FACIAL PAIN

NO H/O SWELLING IN NECK
NO H/O SNORING
NO H/O NASAL REGURGITATION
NO H/O CHRONIC FEVER,COUGH WITH EXPECTORATION
NO H/O LOSS OF WEIGHT AND LOSS OF APPETITE
NO H/O LOOSENING OF TEETH
NO H/O SLEEP DISTURBANCES

PAST HISTORY
-H/O ENDOSCOPIC EXCISION AND CAUTERIZATION DONE IN
PRIVATE HOSPITAL 2010 AND GRH 2012 MADURAI FOR
RHINOSPORIDIOSIS
-NOT A K/C/O
DIABETES,HYPERTENSION,TUBERCULOSIS,BRONCHIAL
ASTHMA,EPILEPSY.
-NO H/O DRUG INTAKE FOR ANY CHRONIC ILLNESS
-NO H/O ANY KNOWN DRUG ALLERGY/ALLERGEN

PERSONAL HISTORY

-H/O BATHING IN POND

-NOT A ALCHOLIC NOR SMOKER/SNUFFING
-NO H/O EXPOSURE TO CHEMICAL DYES,WOOD DUST.
-MIXED DIET
-BOWEL AND BLADDER HABITS NORMAL

FAMILY HISTORY
-NO H/O SIMILAR ILLNESS RUNNING IN FAMILY MEMBERS

MENSTRUAL HISTORY
LMP- 8 MONTHS BACK
H/O FAMILY PLANNING DONE 20 YRS BACK

VITALS STABLE
GENERAL EXAMINATION:
CVS-S1 S2 NORMAL,NO MURMURS
RS-B/L AIR ENTRY-EQUAL,NORMAL VESICULAR BREATH
SOUNDS
P/A-SOFT,NO ORGANOMEGALY
CNS-NO FOCAL NEUROLOGICAL DEFICIT

 LOCAL EXAMINATION
NOSE:
EXTERNAL CONTOUR-NO DEFORMITY
-NO SWELLING
-NO COLUMELLAR RETRACTION
-NO NASOLABIAL FOLD OBLITERATION
-NO WIDENING OF BRIDGE OF NOSE
NO WIDENING OF INTERCANTHAL
DISTANCE

 PARANASAL SINUSES EXAMINATION

- NO TENDERNESS IN
FRONTAL,ETHMOIDAL,MAXILLARY REGIONS.
EXAMINATION OF ORAL CAVITY:
- LIPS,GINGIVA,BUCCAL
MUCOSA,ANTERIOR TWOTHIRD TONGUE,HARD
PALATE,RETROMOLAR TRIGONE-NORMAL
-DENTAL FORMULA-2123/2123

 EAR:
BILATERAL EXTERNAL AUDITORY CANAL-NORMAL
BILATERAL TYMPANIC MEMBRANE INTACT
LARYNX:
IDL EXAMINATION-NORMAL STUDY
NECK:
NO SIGNIFICANT LYMPH NODES,SWELLING IN NECK
OR ABNORMAL PULSATIONS

RECURRENT
RHINOSPORIDIOSIS

PROVISIONAL DIAGNOSIS:

CT PNS

INVESTIGATIONS:
ROUTINE BLOOD INVESTIGATIONS
ECG
X-RAY PNS
CT-PNS
DNE
MANAGEMENT:

ENDOSCOPIC COBLATION
EXCISION

THANK YOU