Difference between revisions of "Rhinitis"

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{{toplink
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==Introduction==
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|backcolour = D1EEEE
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[[Image:Mucoid rhinitis.jpg|right|thumb|200px|<small><center>Mucoid rhinitis (Image sourced from Bristol Biomed Image Archive with permission)</center></small>]]
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|linkpage =Cardiorespiratory System - Pathology
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|linktext =Cardiorespiratory System
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Rhinitis can be acute or chronic.
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|maplink = Cardiorespiratory System (Content Map) - Pathology
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|pagetype =Pathology
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Its aetiology can be:
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|sublink1=Nasal Cavity - Pathology
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:Infectious
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|subtext1=NASAL CAVITY
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:Allergic
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}}
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:Toxic
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<br>
+
:Traumatic e.g. foreign bodies
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'''For an overview of respiratory infections see [[Respiratory System Inflammation - Pathology]]'''
+
 
 +
Serous cells are usually the first to respond to a noxious agent, releasing secretions into the mucocilliary blanket.
  
 +
Different forms of rhinitis can be described:
  
−
==Rhinitis==
+
'''Serous rhinitis''' is the typical mild 'runny nose'. There is loss of cilia and hydropic degeneration of epithelial cells. The epithelium becomes susceptible to secondary bacterial infections, including overgrowth of resident nasopharyngeal flora. Goblet cells become stimulated, changing the secretions into a thick opaque mucus.
−
[[Image:Mucoid rhinitis.jpg|right|thumb|100px|<small><center>Mucoid rhinitis (Image sourced from Bristol Biomed Image Archive with permission)</center></small>]]
 
  
−
*Acute or chronic
+
'''Catarrhal rhinitis''' can follow serous rhinitis. It contains mucus, emigrating leukocytes and few sloughed epithelial cells.
−
*Aetiology
 
−
**Infectious
 
−
**Allergic
 
−
**Toxic
 
−
**Traumatic e.g. foreign bodies
 
  
−
*Serous cells usually first to respond to a noxious agent, releasing secretions into the mucocilliary blanket
+
'''Mucopurulent''' and then '''purulent rhinitis'''occurs when secondary bacterial infection is severe, migrating [[Neutrophils|neutrophils]] are present in the exudate.
  
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*'''Serous rhinitis''' - typical mild 'runny nose'
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More severe damage to the nasal mucosa causes vascular permeability and seepage of large molecular weight proteins, including fibrinogen, into the exudate leading to '''fibrinopurulent''' and '''fibrinous rhinitis'''.
−
**Loss of cilia and hydropic degeneration of epithelial cells
 
−
**Epithelium becomes susceptible to secondary bacterial infections, including overgrowth of resident nasopharyngeal flora
 
−
**Goblet cells become stimulated, changing the secretions into a thick opaque mucus ->
 
−
*'''Catarrhal rhinitis'''
 
−
**Contains mucus, emigrating leukocytes and few sloughed epithelial cells
 
−
*'''Mucopurulent''' and then '''purulent rhinitis'''
 
−
**When secondary bacterial infection is severe, migrating neutrophils pour into the exudate
 
−
**More severe damage to the nasal mucosa causes vascular permeability and seepage of large molecular weight proteins, including fibrinogen, into the exudate ->
 
−
*'''Fibrinopurulent''' and '''fibrinous rhinitis'''
 
−
*'''Fibronecrotic''' and '''ulcerative rhinitis''' are manifestations of very severe damage to the nasal mucosa
 
  
 +
'''Fibronecrotic''' and '''ulcerative rhinitis''' are manifestations of very severe damage to the nasal mucosa.
  
 
==Chronic rhinitis==
 
==Chronic rhinitis==
−
*Happens when acute rhinitis fails to resolve - common
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This occurs when acute rhinitis fails to resolve and is common in most species. It is typically catarrhal or purulent in nature.
−
*Typically catarrhal or purulent
 
−
*In chronic purulent rhinitis
 
−
**Extensive fibrosis of the lamina propria
 
−
**Atrophy of nasal glands
 
−
**Squamous cell [[General Pathology - Disorders of Cell Growth#Metaplasia|metaplasia]]
 
−
*-> Impaired local defences
 
−
*Superficial fibrinous membrane can be peeled of without leaving dmaged tissue underneath
 
−
*Deeper fibronecrotic lesions associated with [[Fusobacterium|''Fusobacterium necrophorum'']] - yellowish fibronecrotic membrane, when removed, leaves ulcerated surface
 
−
*May manifest as [[Nasal Cavity Hyperplastic and Neoplastic - Pathology#Nasal polyps|nasal polyps]], [[Nasal Cavity Hyperplastic and Neoplastic - Pathology#Progressive ethmoidal haematoma|progressive haematoma]] in horses and [[Nasopharynx Hyperplastic and Neoplastic - Pathology#Nasopharyngeal polyp of cats|nasopharyngeal polyp]] of cats
 
  
 +
In chronic purulent rhinitis there is extensive fibrosis of the lamina propria, atrophy of the nasal glands and squamous cell [[Cell Growth Disorders#Metaplasia|metaplasia]]. These all result in impaired local defences.
 +
 +
Usually, the superficial fibrinous membrane can be peeled off without leaving damaged tissue underneath.
 +
 +
Deeper fibronecrotic lesions associated with [[Fusobacterium necrophorum|''Fusobacterium necrophorum'']] appear as a yellowish fibronecrotic membrane, which when removed leaves an ulcerated surface.
 +
 +
Chronic rhinitis may manifest as nasal polyps, [[Progressive Ethmoidal Haematoma|progressive haematoma]] in horses and [[Nasopharyngeal Polyp|nasopharyngeal polyps]] of cats.
  
 
==Allergic rhinitis==
 
==Allergic rhinitis==
  
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*Occurs in dogs, cats and horses, may occur seasonally in cattle, especially Channel Island breeds
+
This occurs in dogs, cats and horses, and may occur seasonally in cattle, especially Channel Island breeds.
−
*Similar inflammatory changes as above
 
−
*Due to hypersensitivity to inhaled allergens
 
−
*Eosinophils tend to be the dominant infiltrating leukocytes
 
−
*Grossly:
 
−
**Pale, thick, oedematous nasal mucosa
 
−
*Histologically:
 
−
**Hyperplastic, eroded nasal epithelium, eosinophil infiltrate
 
  
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*If chronic -> '''Nasal granuloma'''
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There are similar inflammatory changes as above, due to [[hypersensitivity]] to inhaled allergens. [[Eosinophils]] tend to be the dominant infiltrating leukocytes.
−
**Extends caudally, even to larynx and proximal trachea
 
−
**Grossly:
 
−
***Granular hyperplastic epithelium with multiple nodules covered by normal epithelium
 
−
**Hisologically:
 
−
***Centre of [[General Pathology - Chronic Inflammation#Granulation tissue|granulation tissue]] surrounded by oedematous lamina propria covered by hyperplastic epithelium
 
−
***Goblet cell hyperplasia
 
−
***Eosinophil infiltration
 
  
 +
Grossly: the nasal mucosa is pale, thick and oedematous.
  
 +
Histologically: the nasal epithelium is hyperplastic and eroded with an eosinophil infiltrate.
  
−
[[Paranasal Sinuses Inflammatory - Pathology#Sinusitis|'''Sinusitis''']] '''is a common sequel to rhinitis'''
+
If the condition is chronic it may become a '''nasal granuloma''', which extends caudally, even to the larynx and proximal trachea.
 +
:Grossly there is granular hyperplastic epithelium with multiple nodules covered by normal epithelium.
 +
:Histologically there is a centre of [[Granulation Tissue|granulation tissue]] surrounded by oedematous lamina propria covered by hyperplastic epithelium, goblet cell hyperplasia and eosinophil infiltration.
 +
 
 +
 
 +
[[Sinusitis|'''Sinusitis''']] '''is a common sequel to rhinitis'''
  
  
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{| cellpadding="10" cellspacing="0" border="1"  
 
{| cellpadding="10" cellspacing="0" border="1"  
 
| .
 
| .
−
| [[Respiratory Viral Infections - Pathology|'''VIRAL''']]
+
| [[:Category:Respiratory Viral Infections|'''VIRAL''']]
−
| [[Respiratory Bacterial Infections - Pathology|'''BACTERIAL''']]
+
| [[:Category:Respiratory Bacterial Infections|'''BACTERIAL''']]
−
| [[Respiratory Fungal Infections - Pathology|'''FUNGAL''']]
+
| [[:Category:Respiratory Fungal Infections|'''FUNGAL''']]
−
| [[Respiratory Parasitic Infections - Pathology|'''PARASITIC''']]
+
| [[:Category:Respiratory Parasitic Infections|'''PARASITIC''']]
 
|-
 
|-
 
| '''Dogs'''
 
| '''Dogs'''
−
| [[Respiratory Viral Infections - Pathology#Canine distemper|Canine distemper]]
+
| [[Canine Distemper Virus|Canine distemper]]
 
| secondary
 
| secondary
−
| [[Respiratory Fungal Infections - Pathology#In Dogs|''A. fumigatus'']]
+
| [[Aspergillus spp.|''A. fumigatus'']]
−
| [[Respiratory Parasitic Infections - Pathology#In Dogs|''Linguatula serrata]]
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| ''[[Linguatula serrata]]
 
|-
 
|-
 
| .
 
| .
−
| [[Respiratory Viral Infections - Pathology#Parainfluenza- 2|Parainfluenza- 2]]
+
| [[Canine Parainfluenza - 2|Parainfluenza- 2]]
 
| .
 
| .
−
| [[Respiratory Fungal Infections - Pathology#In Dogs|''C. neoformans'']]
+
| [[Cryptococcus neoformans|''C. neoformans'']]
−
| [[Respiratory Parasitic Infections - Pathology#Capillaria aerophila|''Capillaria aerophila'']]
+
| [[Capillaria|''Capillaria aerophila'']]
 
|-
 
|-
 
| .
 
| .
−
| [[Respiratory Viral Infections - Pathology#Canine herpes virus|Canine herpes virus]]
+
| [[Canine Herpesvirus 1|Canine herpes virus]]
 
| .
 
| .
 
| .
 
| .
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|-
 
|-
 
| '''Cats'''
 
| '''Cats'''
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| [[Respiratory Viral Infections - Pathology#Feline viral rhinotracheitis|Feline viral rhinotracheitis]]  
+
| [[Feline Herpesvirus 1|Feline viral rhinotracheitis]]  
 
| secondary
 
| secondary
−
| [[Respiratory Fungal Infections - Pathology#In Cats|''Cryptococcus neoformans'']]
+
| [[Cryptococcus neoformans|''Cryptococcus neoformans'']]
−
| [[Respiratory Parasitic Infections - Pathology#In Cats|''Linguatula serrata]] sometimes
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| ''[[Linguatula serrata]]'' sometimes
 
|-
 
|-
 
| .
 
| .
−
| [[Respiratory Viral Infections - Pathology#Feline calicivirus|Feline calicivirus]]
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| [[Feline Calicivirus|Feline calicivirus]]
 
| .
 
| .
−
| [[Respiratory Fungal Infections - Pathology#In Cats|''Aspergillus fumigatus'']]
+
| [[Aspergillus spp.|''Aspergillus fumigatus'']]
−
| [[Respiratory Parasitic Infections - Pathology#Capillaria aerophila|''Capillaria aerophila'']]
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| [[Capillaria|''Capillaria aerophila'']]
 
|-
 
|-
 
| '''Horses'''
 
| '''Horses'''
−
| [[Respiratory Viral Infections - Pathology#Equine rhinovirus|Equine rhinovirus]]
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| [[Equine Rhinovirus|Equine rhinovirus]]
−
| [[Respiratory Bacterial Infections - Pathology#Strangles|Strangles]]
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| [[Strangles|Strangles]]
−
| [[Respiratory Fungal Infections - Pathology#In Horses|''Aspergillus'' spp.]]
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| [[Aspergillus spp.|''Aspergillus'' spp.]]
−
| [[Respiratory Parasitic Infections - Pathology#In Horses|''Parascaris equorum'']]
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| ''[[Parascaris equorum]]''
 
|-
 
|-
 
| .
 
| .
−
| [[Respiratory Viral Infections - Pathology#Equine influenza|Equine influenza]]
+
| [[Equine Influenza|Equine influenza]]
−
| [[Respiratory Bacterial Infections - Pathology#Streptococcus equi subsp. zooepidemicus|''Streptococcus equi subsp. zooepidemicus'']]  
+
| [[Streptococcus equi subsp. zooepidemicus|''Streptococcus equi subsp. zooepidemicus'']]  
 
| .
 
| .
 
| .
 
| .
 
|-
 
|-
 
| .
 
| .
−
| [[Respiratory Viral Infections - Pathology#Equine rhinopneumonitis|Equine rhinopneumonitis]]
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| [[Equine Rhinopneumonitis|Equine rhinopneumonitis]]
−
| [[Respiratory Bacterial Infections - Pathology#Glanders|Glanders]]
+
| [[Glanders|Glanders]]
 
| .
 
| .
 
| .
 
| .
 
|-
 
|-
 
| .
 
| .
−
| [[Respiratory Viral Infections - Pathology#Equine viral arteritis (EVA)|Equine viral arteritis]]
+
| [[Equine Viral Arteritis|Equine viral arteritis]]
 
| .
 
| .
 
| .
 
| .
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|-
 
|-
 
| '''Cattle'''
 
| '''Cattle'''
−
| [[Respiratory Viral Infections - Pathology#Infectious bovine rhinotracheitis (IBR)|Infectious bovine rhinotracheitis]]
+
| [[Infectious Bovine Rhinotracheitis|Infectious bovine rhinotracheitis]]
 
| secondary
 
| secondary
 
| .
 
| .
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|-
 
|-
 
| .
 
| .
−
| [[Respiratory Viral Infections - Pathology#Parainfluenza- 3|Parainfluenza- 3]]
+
| [[Bovine Parainfluenza - 3|Parainfluenza- 3]]
−
| subclinical [[Respiratory Bacterial Infections - Pathology#CAR bacillus|''CAR bacillus'']]
+
| subclinical [[Cillia-Associated Respiratory Bacillus|''CAR bacillus'']]
 
| .
 
| .
 
| .
 
| .
 
|-
 
|-
 
| .
 
| .
−
| [[Respiratory Viral Infections - Pathology#Bovine adenovirus|Bovine adenovirus]]
+
| [[Bovine Adenovirus|Bovine adenovirus]]
 
| .
 
| .
 
| .
 
| .
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|-
 
|-
 
| '''Sheep'''
 
| '''Sheep'''
−
| [[Respiratory Viral Infections - Pathology#Parainfluenza- 3|Parainfluenza- 3]]
+
| [[Bovine Parainfluenza - 3|Parainfluenza - 3]]
−
| subclinical [[Respiratory Bacterial Infections - Pathology#CAR bacillus|''CAR bacillus'']]
+
| subclinical [[Cillia-Associated Respiratory Bacillus|''CAR bacillus'']]
 
| .
 
| .
−
| [[Respiratory Parasitic Infections - Pathology#Oestrus ovis|''Oestrus ovis'' larvae]]
+
| [[Oestrus ovis|''Oestrus ovis'' larvae]]
 
|-
 
|-
 
| '''Pigs'''
 
| '''Pigs'''
−
| [[Respiratory Viral Infections - Pathology#Inclusion body rhinitis|Inclusion body rhinitis]]
+
| [[Inclusion Body Rhinitis|Inclusion body rhinitis]]
−
| [[Respiratory Bacterial Infections - Pathology#Atrophic Rhinitis|Atrophic rhinitis]]
+
| [[Atrophic Rhinitis|Atrophic rhinitis]]
 
| .
 
| .
 
| .
 
| .
 
|-
 
|-
 
| .
 
| .
−
| [[Respiratory Viral Infections - Pathology#Swine influenza|Swine influenza]]
+
| [[Swine Influenza|Swine influenza]]
 
| .
 
| .
 
| .
 
| .
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|-
 
|-
 
|}
 
|}
 +
 +
{{Learning
 +
|flashcards = [[Nasal_Cavity_Flashcards_-_Pathology|Nasal Cavity Pathology Flashcards]]<br>[[Small Animal Soft Tissue Surgery Q&A 10]]
 +
}}
  
  
−
'''For an overview of respiratory infections see [[Respiratory System Inflammation - Pathology]]'''
+
[[Category:Respiratory System - Inflammatory Pathology]]
 +
[[Category:Nasal Cavity - Inflammatory Pathology]]

Latest revision as of 13:18, 19 October 2011

Introduction

Mucoid rhinitis (Image sourced from Bristol Biomed Image Archive with permission)

Rhinitis can be acute or chronic.

Its aetiology can be:

Infectious
Allergic
Toxic
Traumatic e.g. foreign bodies

Serous cells are usually the first to respond to a noxious agent, releasing secretions into the mucocilliary blanket.

Different forms of rhinitis can be described:

Serous rhinitis is the typical mild 'runny nose'. There is loss of cilia and hydropic degeneration of epithelial cells. The epithelium becomes susceptible to secondary bacterial infections, including overgrowth of resident nasopharyngeal flora. Goblet cells become stimulated, changing the secretions into a thick opaque mucus.

Catarrhal rhinitis can follow serous rhinitis. It contains mucus, emigrating leukocytes and few sloughed epithelial cells.

Mucopurulent and then purulent rhinitisoccurs when secondary bacterial infection is severe, migrating neutrophils are present in the exudate.

More severe damage to the nasal mucosa causes vascular permeability and seepage of large molecular weight proteins, including fibrinogen, into the exudate leading to fibrinopurulent and fibrinous rhinitis.

Fibronecrotic and ulcerative rhinitis are manifestations of very severe damage to the nasal mucosa.

Chronic rhinitis

This occurs when acute rhinitis fails to resolve and is common in most species. It is typically catarrhal or purulent in nature.

In chronic purulent rhinitis there is extensive fibrosis of the lamina propria, atrophy of the nasal glands and squamous cell metaplasia. These all result in impaired local defences.

Usually, the superficial fibrinous membrane can be peeled off without leaving damaged tissue underneath.

Deeper fibronecrotic lesions associated with Fusobacterium necrophorum appear as a yellowish fibronecrotic membrane, which when removed leaves an ulcerated surface.

Chronic rhinitis may manifest as nasal polyps, progressive haematoma in horses and nasopharyngeal polyps of cats.

Allergic rhinitis

This occurs in dogs, cats and horses, and may occur seasonally in cattle, especially Channel Island breeds.

There are similar inflammatory changes as above, due to hypersensitivity to inhaled allergens. Eosinophils tend to be the dominant infiltrating leukocytes.

Grossly: the nasal mucosa is pale, thick and oedematous.

Histologically: the nasal epithelium is hyperplastic and eroded with an eosinophil infiltrate.

If the condition is chronic it may become a nasal granuloma, which extends caudally, even to the larynx and proximal trachea.

Grossly there is granular hyperplastic epithelium with multiple nodules covered by normal epithelium.
Histologically there is a centre of granulation tissue surrounded by oedematous lamina propria covered by hyperplastic epithelium, goblet cell hyperplasia and eosinophil infiltration.


Sinusitis is a common sequel to rhinitis


Infectious causes of rhinitis

. VIRAL BACTERIAL FUNGAL PARASITIC
Dogs Canine distemper secondary A. fumigatus Linguatula serrata
. Parainfluenza- 2 . C. neoformans Capillaria aerophila
. Canine herpes virus . . .
Cats Feline viral rhinotracheitis secondary Cryptococcus neoformans Linguatula serrata sometimes
. Feline calicivirus . Aspergillus fumigatus Capillaria aerophila
Horses Equine rhinovirus Strangles Aspergillus spp. Parascaris equorum
. Equine influenza Streptococcus equi subsp. zooepidemicus . .
. Equine rhinopneumonitis Glanders . .
. Equine viral arteritis . . .
Cattle Infectious bovine rhinotracheitis secondary . .
. Parainfluenza- 3 subclinical CAR bacillus . .
. Bovine adenovirus . . .
Sheep Parainfluenza - 3 subclinical CAR bacillus . Oestrus ovis larvae
Pigs Inclusion body rhinitis Atrophic rhinitis . .
. Swine influenza . . .


Rhinitis Learning Resources
FlashcardsFlashcards logo.png
Flashcards
Test your knowledge using flashcard type questions 		Nasal Cavity Pathology Flashcards
Small Animal Soft Tissue Surgery Q&A 10


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