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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Its aetiology can be:
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|linkpage =Cardiorespiratory System - Pathology
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:Infectious
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|linktext =Cardiorespiratory System
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:Allergic
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|maplink = Cardiorespiratory System (Content Map) - Pathology
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:Toxic
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|pagetype =Pathology
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:Traumatic e.g. foreign bodies
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|sublink1=Nasal Cavity - Pathology
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|subtext1=NASAL CAVITY
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Serous cells are usually the first to respond to a noxious agent, releasing secretions into the mucocilliary blanket.
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}}
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<br>
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'''For an overview of respiratory infections see [[Respiratory System Inflammation - Pathology]]'''
  
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Different forms of rhinitis can be described:
 
  
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'''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.
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==Rhinitis==
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[[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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'''Catarrhal rhinitis''' can follow serous rhinitis. It contains mucus, emigrating leukocytes and few sloughed epithelial cells.
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*Acute or chronic
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*Aetiology
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**Infectious
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**Allergic
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**Toxic
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**Traumatic e.g. foreign bodies
  
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'''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 cells usually first to respond to a noxious agent, releasing secretions into the mucocilliary blanket
  
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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'''.
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*'''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 ->
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*'''Catarrhal rhinitis'''
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**Contains mucus, emigrating leukocytes and few sloughed epithelial cells
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*'''Mucopurulent''' and then '''purulent rhinitis'''
 +
**When secondary bacterial infection is severe, migrating [[Neutrophils|neutrophils]] pour into the exudate
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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 ->
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*'''Fibrinopurulent''' and '''fibrinous rhinitis'''
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*'''Fibronecrotic''' and '''ulcerative rhinitis''' are manifestations of very severe damage to the nasal mucosa
  
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'''Fibronecrotic''' and '''ulcerative rhinitis''' are manifestations of very severe damage to the nasal mucosa.
 
  
 
==Chronic rhinitis==
 
==Chronic rhinitis==
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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.
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*Happens when acute rhinitis fails to resolve - common
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*Typically catarrhal or purulent
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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.
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*In chronic purulent rhinitis
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**Extensive fibrosis of the lamina propria
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Usually, the superficial fibrinous membrane can be peeled off without leaving damaged tissue underneath.
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**Atrophy of nasal glands
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**Squamous cell [[Disorders of Cell Growth - Pathology#Metaplasia|metaplasia]]
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Deeper fibronecrotic lesions associated with [[Fusobacterium necrophorum|''Fusobacterium necrophorum'']] appear as a yellowish fibronecrotic membrane, which when removed leaves an ulcerated surface.
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*-> Impaired local defences
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*Superficial fibrinous membrane can be peeled of without leaving dmaged tissue underneath
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*Deeper fibronecrotic lesions associated with [[Fusobacterium|''Fusobacterium necrophorum'']] - yellowish fibronecrotic membrane, when removed, leaves ulcerated surface
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*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
  
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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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This occurs in dogs, cats and horses, and may occur seasonally in cattle, especially Channel Island breeds.
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*Occurs in dogs, cats and horses, may occur seasonally in cattle, especially Channel Island breeds
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*Similar inflammatory changes as above
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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.
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*Due to hypersensitivity to inhaled allergens
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*Eosinophils tend to be the dominant infiltrating leukocytes
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*Grossly:
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**Pale, thick, oedematous nasal mucosa
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*Histologically:
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**Hyperplastic, eroded nasal epithelium, eosinophil infiltrate
  
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Grossly: the nasal mucosa is pale, thick and oedematous.
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*If chronic -> '''Nasal granuloma'''
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**Extends caudally, even to larynx and proximal trachea
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**Grossly:
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***Granular hyperplastic epithelium with multiple nodules covered by normal epithelium
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**Hisologically:
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***Centre of [[Granulation Tissue|granulation tissue]] surrounded by oedematous lamina propria covered by hyperplastic epithelium
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***Goblet cell hyperplasia
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***Eosinophil infiltration
  
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Histologically: the nasal epithelium is hyperplastic and eroded with an eosinophil infiltrate.
 
  
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If the condition is chronic it may become a '''nasal granuloma''', which extends caudally, even to the larynx and proximal trachea.
 
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:Grossly there is granular hyperplastic epithelium with multiple nodules covered by normal epithelium.
 
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: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.
 
  
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[[Paranasal Sinuses Inflammatory - Pathology#Sinusitis|'''Sinusitis''']] '''is a common sequel to rhinitis'''
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[[Sinusitis|'''Sinusitis''']] '''is a common sequel to rhinitis'''
 
  
  
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{{Learning
 
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|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]]
 
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[[Category:Nasal Cavity - Inflammatory Pathology]]
 

Revision as of 11:34, 4 August 2010

 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 . . .
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