Difference between revisions of "Rhinitis"

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==Introduction==
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{{review}}
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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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Rhinitis can be acute or chronic.
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{{toplink
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|backcolour = D1EEEE
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|linkpage =Cardiorespiratory System - Pathology
 +
|linktext =Cardiorespiratory System
 +
|maplink = Cardiorespiratory System (Content Map) - Pathology
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|pagetype =Pathology
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|sublink1=Nasal Cavity - Pathology
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|subtext1=NASAL CAVITY
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}}
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<br>
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'''For an overview of respiratory infections see [[Respiratory System Inflammation - Pathology]]'''
  
−
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.
+
==Rhinitis==
 +
[[Image:Mucoid rhinitis.jpg|right|thumb|100px|<small><center>Mucoid rhinitis (Image sourced from Bristol Biomed Image Archive with permission)</center></small>]]
  
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Different forms of rhinitis can be described:
+
*Acute or chronic
 +
*Aetiology
 +
**Infectious
 +
**Allergic
 +
**Toxic
 +
**Traumatic e.g. foreign bodies
  
−
'''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.
+
*Serous cells usually first to respond to a noxious agent, releasing secretions into the mucocilliary blanket
  
−
'''Catarrhal rhinitis''' can follow serous rhinitis. It contains mucus, emigrating leukocytes and few sloughed epithelial cells.
+
*'''Serous rhinitis''' - typical mild 'runny nose'
 +
**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
  
−
'''Mucopurulent''' and then '''purulent rhinitis'''occurs when secondary bacterial infection is severe, migrating [[Neutrophils|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==
 
==Chronic rhinitis==
−
This occurs when acute rhinitis fails to resolve and is common in most species. It is typically catarrhal or purulent in nature.
+
*Happens when acute rhinitis fails to resolve - common
−
 
+
*Typically catarrhal or purulent
−
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.
+
*In chronic purulent rhinitis
−
 
+
**Extensive fibrosis of the lamina propria
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Usually, the superficial fibrinous membrane can be peeled off without leaving damaged tissue underneath.
+
**Atrophy of nasal glands
−
 
+
**Squamous cell [[Disorders of Cell Growth - Pathology#Metaplasia|metaplasia]]
−
Deeper fibronecrotic lesions associated with [[Fusobacterium necrophorum|''Fusobacterium necrophorum'']] appear as a yellowish fibronecrotic membrane, which when removed leaves an ulcerated surface.
+
*-> 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
  
−
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==
  
−
This occurs in dogs, cats and horses, and may occur seasonally in cattle, especially Channel Island breeds.
+
*Occurs in dogs, cats and horses, 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
  
−
There are similar inflammatory changes as above, due to [[hypersensitivity]] to inhaled allergens. [[Eosinophils]] tend to be the dominant infiltrating leukocytes.
+
*If chronic -> '''Nasal granuloma'''
 +
**Extends caudally, even to larynx and proximal trachea
 +
**Grossly:
 +
***Granular hyperplastic epithelium with multiple nodules covered by normal epithelium
 +
**Hisologically:
 +
***Centre of [[Chronic Inflammation - Pathology#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.
 
  
−
If the condition is chronic it may become a '''nasal granuloma''', which extends caudally, even to the larynx and proximal trachea.
+
[[Paranasal Sinuses Inflammatory - Pathology#Sinusitis|'''Sinusitis''']] '''is a common sequel to rhinitis'''
−
: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"  
 
| .
 
| .
−
| [[:Category:Respiratory Viral Infections|'''VIRAL''']]
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| [[Respiratory Viral Infections - Pathology|'''VIRAL''']]
−
| [[:Category:Respiratory Bacterial Infections|'''BACTERIAL''']]
+
| [[Respiratory Bacterial Infections - Pathology|'''BACTERIAL''']]
−
| [[:Category:Respiratory Fungal Infections|'''FUNGAL''']]
+
| [[Respiratory Fungal Infections - Pathology|'''FUNGAL''']]
−
| [[:Category:Respiratory Parasitic Infections|'''PARASITIC''']]
+
| [[Respiratory Parasitic Infections - Pathology|'''PARASITIC''']]
 
|-
 
|-
 
| '''Dogs'''
 
| '''Dogs'''
−
| [[Canine Distemper Virus|Canine distemper]]
+
| [[Respiratory Viral Infections - Pathology#Canine distemper|Canine distemper]]
 
| secondary
 
| secondary
−
| [[Aspergillus spp.|''A. fumigatus'']]
+
| [[Respiratory Fungal Infections - Pathology#In Dogs|''A. fumigatus'']]
−
| ''[[Linguatula serrata]]
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| [[Respiratory Parasitic Infections - Pathology#In Dogs|''Linguatula serrata]]
 
|-
 
|-
 
| .
 
| .
−
| [[Canine Parainfluenza - 2|Parainfluenza- 2]]
+
| [[Respiratory Viral Infections - Pathology#Parainfluenza- 2|Parainfluenza- 2]]
 
| .
 
| .
−
| [[Cryptococcus neoformans|''C. neoformans'']]
+
| [[Respiratory Fungal Infections - Pathology#In Dogs|''C. neoformans'']]
−
| [[Capillaria|''Capillaria aerophila'']]
+
| [[Respiratory Parasitic Infections - Pathology#Capillaria aerophila|''Capillaria aerophila'']]
 
|-
 
|-
 
| .
 
| .
−
| [[Canine Herpesvirus 1|Canine herpes virus]]
+
| [[Respiratory Viral Infections - Pathology#Canine herpes virus|Canine herpes virus]]
 
| .
 
| .
 
| .
 
| .
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|-
 
|-
 
| '''Cats'''
 
| '''Cats'''
−
| [[Feline Herpesvirus 1|Feline viral rhinotracheitis]]  
+
| [[Respiratory Viral Infections - Pathology#Feline viral rhinotracheitis|Feline viral rhinotracheitis]]  
 
| secondary
 
| secondary
−
| [[Cryptococcus neoformans|''Cryptococcus neoformans'']]
+
| [[Respiratory Fungal Infections - Pathology#In Cats|''Cryptococcus neoformans'']]
−
| ''[[Linguatula serrata]]'' sometimes
+
| [[Respiratory Parasitic Infections - Pathology#In Cats|''Linguatula serrata]] sometimes
 
|-
 
|-
 
| .
 
| .
−
| [[Feline Calicivirus|Feline calicivirus]]
+
| [[Respiratory Viral Infections - Pathology#Feline calicivirus|Feline calicivirus]]
 
| .
 
| .
−
| [[Aspergillus spp.|''Aspergillus fumigatus'']]
+
| [[Respiratory Fungal Infections - Pathology#In Cats|''Aspergillus fumigatus'']]
−
| [[Capillaria|''Capillaria aerophila'']]
+
| [[Respiratory Parasitic Infections - Pathology#Capillaria aerophila|''Capillaria aerophila'']]
 
|-
 
|-
 
| '''Horses'''
 
| '''Horses'''
−
| [[Equine Rhinovirus|Equine rhinovirus]]
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| [[Respiratory Viral Infections - Pathology#Equine rhinovirus|Equine rhinovirus]]
−
| [[Strangles|Strangles]]
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| [[Respiratory Bacterial Infections - Pathology#Strangles|Strangles]]
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| [[Aspergillus spp.|''Aspergillus'' spp.]]
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| [[Respiratory Fungal Infections - Pathology#In Horses|''Aspergillus'' spp.]]
−
| ''[[Parascaris equorum]]''
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| [[Respiratory Parasitic Infections - Pathology#In Horses|''Parascaris equorum'']]
 
|-
 
|-
 
| .
 
| .
−
| [[Equine Influenza|Equine influenza]]
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| [[Respiratory Viral Infections - Pathology#Equine influenza|Equine influenza]]
−
| [[Streptococcus equi subsp. zooepidemicus|''Streptococcus equi subsp. zooepidemicus'']]  
+
| [[Respiratory Bacterial Infections - Pathology#Streptococcus equi subsp. zooepidemicus|''Streptococcus equi subsp. zooepidemicus'']]  
 
| .
 
| .
 
| .
 
| .
 
|-
 
|-
 
| .
 
| .
−
| [[Equine Rhinopneumonitis|Equine rhinopneumonitis]]
+
| [[Respiratory Viral Infections - Pathology#Equine rhinopneumonitis|Equine rhinopneumonitis]]
−
| [[Glanders|Glanders]]
+
| [[Respiratory Bacterial Infections - Pathology#Glanders|Glanders]]
 
| .
 
| .
 
| .
 
| .
 
|-
 
|-
 
| .
 
| .
−
| [[Equine Viral Arteritis|Equine viral arteritis]]
+
| [[Respiratory Viral Infections - Pathology#Equine viral arteritis (EVA)|Equine viral arteritis]]
 
| .
 
| .
 
| .
 
| .
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|-
 
|-
 
| '''Cattle'''
 
| '''Cattle'''
−
| [[Infectious Bovine Rhinotracheitis|Infectious bovine rhinotracheitis]]
+
| [[Respiratory Viral Infections - Pathology#Infectious bovine rhinotracheitis (IBR)|Infectious bovine rhinotracheitis]]
 
| secondary
 
| secondary
 
| .
 
| .
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|-
 
|-
 
| .
 
| .
−
| [[Bovine Parainfluenza - 3|Parainfluenza- 3]]
+
| [[Respiratory Viral Infections - Pathology#Parainfluenza- 3|Parainfluenza- 3]]
−
| subclinical [[Cillia-Associated Respiratory Bacillus|''CAR bacillus'']]
+
| subclinical [[Respiratory Bacterial Infections - Pathology#CAR bacillus|''CAR bacillus'']]
 
| .
 
| .
 
| .
 
| .
 
|-
 
|-
 
| .
 
| .
−
| [[Bovine Adenovirus|Bovine adenovirus]]
+
| [[Respiratory Viral Infections - Pathology#Bovine adenovirus|Bovine adenovirus]]
 
| .
 
| .
 
| .
 
| .
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|-
 
|-
 
| '''Sheep'''
 
| '''Sheep'''
−
| [[Bovine Parainfluenza - 3|Parainfluenza - 3]]
+
| [[Respiratory Viral Infections - Pathology#Parainfluenza- 3|Parainfluenza- 3]]
−
| subclinical [[Cillia-Associated Respiratory Bacillus|''CAR bacillus'']]
+
| subclinical [[Respiratory Bacterial Infections - Pathology#CAR bacillus|''CAR bacillus'']]
 
| .
 
| .
−
| [[Oestrus ovis|''Oestrus ovis'' larvae]]
+
| [[Respiratory Parasitic Infections - Pathology#Oestrus ovis|''Oestrus ovis'' larvae]]
 
|-
 
|-
 
| '''Pigs'''
 
| '''Pigs'''
−
| [[Inclusion Body Rhinitis|Inclusion body rhinitis]]
+
| [[Respiratory Viral Infections - Pathology#Inclusion body rhinitis|Inclusion body rhinitis]]
−
| [[Atrophic Rhinitis|Atrophic rhinitis]]
+
| [[Respiratory Bacterial Infections - Pathology#Atrophic Rhinitis|Atrophic rhinitis]]
 
| .
 
| .
 
| .
 
| .
 
|-
 
|-
 
| .
 
| .
−
| [[Swine Influenza|Swine influenza]]
+
| [[Respiratory Viral Infections - Pathology#Swine influenza|Swine influenza]]
 
| .
 
| .
 
| .
 
| .
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|-
 
|-
 
|}
 
|}
−
 
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{{Learning
 
−
|flashcards = [[Nasal_Cavity_Flashcards_-_Pathology|Nasal Cavity Pathology Flashcards]]<br>[[Small Animal Soft Tissue Surgery Q&A 10]]
 
−
}}
 
  
  
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[[Category:Respiratory System - Inflammatory Pathology]]
+
'''For an overview of respiratory infections see [[Respiratory System Inflammation - Pathology]]'''
−
[[Category:Nasal Cavity - Inflammatory Pathology]]
 

Revision as of 21:13, 13 August 2009

 This article has been peer reviewed but is awaiting expert review. If you would like to help with this, please see more information about expert reviewing.


WikiPathWikiPath Banner.png
()Map CARDIORESPIRATORY SYSTEM (Map)
NASAL CAVITY 



For an overview of respiratory infections see Respiratory System Inflammation - Pathology


Rhinitis

Mucoid rhinitis (Image sourced from Bristol Biomed Image Archive with permission)
  • Acute or chronic
  • 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
  • Serous rhinitis - typical mild 'runny nose'
    • 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


Chronic rhinitis

  • Happens when acute rhinitis fails to resolve - common
  • Typically catarrhal or purulent
  • In chronic purulent rhinitis
    • Extensive fibrosis of the lamina propria
    • Atrophy of nasal glands
    • Squamous cell metaplasia
  • -> Impaired local defences
  • Superficial fibrinous membrane can be peeled of without leaving dmaged tissue underneath
  • Deeper fibronecrotic lesions associated with Fusobacterium necrophorum - yellowish fibronecrotic membrane, when removed, leaves ulcerated surface
  • May manifest as nasal polyps, progressive haematoma in horses and nasopharyngeal polyp of cats


Allergic rhinitis

  • Occurs in dogs, cats and horses, 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
  • If chronic -> Nasal granuloma
    • Extends caudally, even to larynx and proximal trachea
    • Grossly:
      • Granular hyperplastic epithelium with multiple nodules covered by normal epithelium
    • Hisologically:
      • Centre of granulation tissue surrounded by oedematous lamina propria covered by hyperplastic epithelium
      • Goblet cell hyperplasia
      • 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 . . .


For an overview of respiratory infections see Respiratory System Inflammation - Pathology

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