Difference between revisions of "Rhinitis"

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'''For an overview of respiratory infections see [[Respiratory System Inflammation - Pathology]]'''
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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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*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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*Serous cells usually first to respond to a noxious agent, releasing secretions into the mucocilliary blanket
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*'''Serous rhinitis''' - typical mild 'runny nose'
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**Loss of cilia and hydropic degeneration of epithelial cells
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**Epithelium becomes susceptible to secondary bacterial infections, including overgrowth of resident nasopharyngeal flora
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**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'''
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**When secondary bacterial infection is severe, migrating 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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='''Chronic rhinitis'''=
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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
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**Extensive fibrosis of the lamina propria
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**Atrophy of nasal glands
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**Squamous cell [[General Pathology - Disorders of Cell Growth#Metaplasia|metaplasia]]
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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#Nasal polyps|nasal polyps]], [[Nasal cavity - hyperplastic and neoplastic#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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='''Allergic rhinitis'''=
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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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*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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 +
*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 [[General Pathology - Chronic Inflammation#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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<big>[[Paranasal Sinuses Inflammatory - Pathology#Sinusitis|'''Sinusitis''']] '''is a common sequel to rhinitis'''</big>
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='''Infectious causes of rhinitis'''=
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{| cellpadding="10" cellspacing="0" border="1"
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| .
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| [[Respiratory Viral Infections - Pathology|'''VIRAL''']]
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| [[Respiratory Bacterial Infections - Pathology|'''BACTERIAL''']]
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| [[Respiratory Fungal Infections - Pathology|'''FUNGAL''']]
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| [[Respiratory Parasitic Infections - Pathology|'''PARASITIC''']]
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|-
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| '''Dogs'''
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| [[Respiratory Viral Infections - Pathology#Canine distemper|Canine distemper]]
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| secondary
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| [[Respiratory Fungal Infections - Pathology#In Dogs|''A. fumigatus'']]
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| [[Respiratory Parasitic Infections - Pathology#In Dogs|''Linguatula serrata]]
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|-
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| .
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| [[Respiratory Viral Infections - Pathology#Parainfluenza- 2|Parainfluenza- 2]]
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| .
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| [[Respiratory Fungal Infections - Pathology#In Dogs|''C. neoformans'']]
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| [[Respiratory Parasitic Infections - Pathology#Capillaria aerophila|''Capillaria aerophila'']]
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|-
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| .
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| [[Respiratory Viral Infections - Pathology#Canine herpes virus|Canine herpes virus]]
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| .
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| .
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| .
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|-
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| '''Cats'''
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| [[Respiratory Viral Infections - Pathology#Feline viral rhinotracheitis|Feline viral rhinotracheitis]]
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| secondary
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| [[Respiratory Fungal Infections - Pathology#In Cats|''Cryptococcus neoformans'']]
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| [[Respiratory Parasitic Infections - Pathology#In Cats|''Linguatula serrata]] sometimes
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|-
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| .
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| [[Respiratory Viral Infections - Pathology#Feline calicivirus|Feline calicivirus]]
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| .
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| [[Respiratory Fungal Infections - Pathology#In Cats|''Aspergillus fumigatus'']]
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| [[Respiratory Parasitic Infections - Pathology#Capillaria aerophila|''Capillaria aerophila'']]
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|-
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| '''Horses'''
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| [[Respiratory Viral Infections - Pathology#Equine rhinovirus|Equine rhinovirus]]
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| [[Respiratory Bacterial Infections - Pathology#Strangles|Strangles]]
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| [[Respiratory Fungal Infections - Pathology#In Horses|''Aspergillus'' spp.]]
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| [[Respiratory Parasitic Infections - Pathology#In Horses|''Parascaris equorum'']]
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|-
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| .
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| [[Respiratory Viral Infections - Pathology#Equine influenza|Equine influenza]]
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| [[Respiratory Bacterial Infections - Pathology#Streptococcus equi subsp. zooepidemicus|''Streptococcus equi subsp. zooepidemicus'']]
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| .
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| .
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|-
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| .
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| [[Respiratory Viral Infections - Pathology#Equine rhinopneumonitis|Equine rhinopneumonitis]]
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| [[Respiratory Bacterial Infections - Pathology#Glanders|Glanders]]
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| .
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| .
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|-
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| .
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| [[Respiratory Viral Infections - Pathology#Equine viral arteritis (EVA)|Equine viral arteritis]]
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| .
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| .
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| .
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|-
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| '''Cattle'''
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| [[Respiratory Viral Infections - Pathology#Infectious bovine rhinotracheitis (IBR)|Infectious bovine rhinotracheitis]]
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| secondary
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| .
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| .
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|-
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| .
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| [[Respiratory Viral Infections - Pathology#Parainfluenza- 3|Parainfluenza- 3]]
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| subclinical [[Respiratory Bacterial Infections - Pathology#CAR bacillus|''CAR bacillus'']]
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| .
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| .
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|-
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| .
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| [[Respiratory Viral Infections - Pathology#Bovine adenovirus|Bovine adenovirus]]
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| .
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| .
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| .
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|-
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| '''Sheep'''
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| [[Respiratory Viral Infections - Pathology#Parainfluenza- 3|Parainfluenza- 3]]
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| subclinical [[Respiratory Bacterial Infections - Pathology#CAR bacillus|''CAR bacillus'']]
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| .
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| [[Respiratory Parasitic Infections - Pathology#Oestrus ovis|''Oestrus ovis'' larvae]]
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|-
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| '''Pigs'''
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| [[Respiratory Viral Infections - Pathology#Inclusion body rhinitis|Inclusion body rhinitis]]
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| [[Respiratory Bacterial Infections - Pathology#Atrophic Rhinitis|Atrophic rhinitis]]
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| .
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| .
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|-
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| .
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| [[Respiratory Viral Infections - Pathology#Swine influenza|Swine influenza]]
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| .
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| .
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| .
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|-
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|}
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'''For an overview of respiratory infections see [[Respiratory System Inflammation - Pathology]]'''

Revision as of 21:33, 4 August 2008

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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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