Patient's question:
The patient is 4 years and 7 months old. Since September 2013, they have been experiencing runny nose after visiting their daughter's grandparents' house every Saturday (the walls of the house with windows had mold due to dampness and smelled). At night, they returned home to sleep with nasal congestion. By December, the nasal congestion was still severe despite treatment for a cold, making it difficult to sleep while lying down. In January 2014, an X-ray revealed adenoid hypertrophy. In March, after surgery, the nasal congestion persisted, and the doctor mentioned mild allergic rhinitis, recommending the use of Orlonma and Biyuantongqiao. These had no effect. In September, an examination showed a 5-degree allergy to house dust mites and dust mites. Sublingual Chuan Di was administered, along with antihistamines, but the nasal congestion persisted, leading to mouth breathing during sleep, and now they have developed an overbite. By January 2015, medication was discontinued. In February 2015, a CT scan at the children's hospital revealed sinusitis. Medication and nasal sprays provided some relief, but occasional allergy symptoms, nasal congestion, and secretions remained. In the morning, they blew their nose with yellow and white nasal discharge, and occasionally experienced nosebleeds.Doctor's answer:
Hello parents! The main symptoms of pediatric allergic rhinitis are nasal congestion, runny nose (mostly clear nasal discharge), sneezing, and nasal itching. It is often related to the season. Allergen testing revealed dust mites, which are perennial allergens, but they can also worsen seasonally. It is best to avoid contact as much as possible. Treatment primarily involves antiallergic therapy and immunotherapy. When symptoms are severe, local nasal steroid sprays (e.g., Beconase) may be used for 2-4 weeks. For more severe cases, nasal antihistamines (e.g., Astelin, Acesulfame) can be used in conjunction, or oral antihistamines (e.g., Claritin or Xyzal) may also be prescribed. If nasal congestion is severe, the focus is on relieving congestion and promoting nasal discharge. Nasal congestion can be treated with oxymetazoline nasal drops, diluted by half for children under 3 years old. For thick nasal discharge, oral mucolytics (e.g., Otrivin or Tioconazole) can be used. Immunotherapy requires 2-3 years, and whether it can be consistently administered sublingually determines the fundamental treatment. It is recommended to persist with the treatment.