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HISTORY OF PRESENTING

ILLNESS

NASAL BLEED 2 YRS

ON AND OFF

ASSC. WITH FORCIBLE NASAL BLOW

LAST EPISODE YESTERDAY MORNING(19/1/2016)

SCANTY AMOUNT

RECURRENT RESPIRATORY TRACT INFECTION

2 TO ! EPISODES EACH MONTH

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H/O NASAL OBSTRUCTIONBILATERAL"GRADUAL

ONSET"PROGRESSI#E IN NATURE"CONTINOUS"AGGRA#ATED

WITH EPISODES OF URTI AND RELIE#ED WITH NASAL

DECONGESTANTS FOR PAST TWO YEARS

H/O NASAL DISCHARGE BILATERAL"ONLY DURING TIMES OF

URTI "WHICH IS MUCOPURULENT"NOT ASSOCIATED WITH

ODOUR.

NO H/O SNEE$ING BOUTS

NO H/O NASAL SWELLING

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NO H/O NASAL PAIN

NO H/O HEADACHE

NO H/O TRAUMA TO NOSE

NO H/O DEFECTI#E #ISION

NO H/O EPIPHORA

NO H/O BLOC%ED SENSATION OF EAR/EAR ACHE

NO H/O EAR DISCHARGE

NO H/O TRISMUS/DIFFICULTY IN CHEWING

NO H/O DYSPHAGIA

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NO H/O FACIAL PAIN NO H/O SWELLING IN NEC%

NO H/O SNORING

NO H/O NASAL REGURGITATION

NO H/O CHRONIC FE#ER"COUGH WITH E&PECTORATION

NO H/O LOSS OF WEIGHT AND LOSS OF APPETITE

NO H/O LOOSENING OF TEETH

NO H/O SLEEP DISTURBANCES

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PAST HISTORY

H/O ENDOSCOPIC E&CISION AND CAUTERI$ATION DONE IN

PRI#ATE HOSPITAL 2010 AND GRH 2012 MADURAI FOR

RHINOSPORIDIOSIS

NOT A %/C/O

DIABETES"HYPERTENSION"TUBERCULOSIS"BRONCHIAL

ASTHMA"EPILEPSY.

NO H/O DRUG INTA%E FOR ANY CHRONIC ILLNESS

NO H/O ANY %NOWN DRUG ALLERGY/ALLERGEN

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PERSONAL HISTORY

H/O BATHING IN POND

NOT A ALCHOLIC NOR SMO%ER/SNUFFINGNO H/O E&POSURE TO CHEMICAL DYES"WOOD DUST.

MI&ED DIET

BOWEL AND BLADDER HABITS NORMAL

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FAMILY HISTORY

NO H/O SIMILAR ILLNESS RUNNING IN FAMILY MEMBERS

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MENSTRUAL HISTORY

LMP ' MONTHS BAC%

H/O FAMILY PLANNING DONE 20 YRS BAC%

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#ITALS STABLE

GENERAL E&AMINATION

C#SS1 S2 NORMAL"NO MURMURS

RSB/L AIR ENTRYEUAL"NORMAL #ESICULAR BREATH

SOUNDS

P/ASOFT"NO ORGANOMEGALY

CNSNO FOCAL NEUROLOGICAL DEFICIT

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LOCAL E&AMINATION

NOSE

E&TERNAL CONTOURNO DEFORMITY

NO SWELLING

NO COLUMELLAR RETRACTION

NO NASOLABIAL FOLD OBLITERATION

NO WIDENING OF BRIDGE OF NOSE

NO WIDENING OF INTERCANTHAL

DISTANCE

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PARANASAL SINUSES E&AMINATION

NO TENDERNESS IN

FRONTAL"ETHMOIDAL"MA&ILLARY REGIONS.

E&AMINATION OF ORAL CA#ITY

LIPS"GINGI#A"BUCCAL

MUCOSA"ANTERIOR TWOTHIRD TONGUE"HARD

PALATE"RETROMOLAR TRIGONENORMAL DENTAL FORMULA212!/212!

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EAR

BILATERAL E&TERNAL AUDITORY CANALNORMAL

BILATERAL TYMPANIC MEMBRANE INTACT

LARYN&

IDL E&AMINATIONNORMAL STUDY

NEC% NO SIGNIFICANT LYMPH NODES"SWELLING IN NEC%

OR ABNORMAL PULSATIONS

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PRO#ISIONAL DIAGNOSIS RECURRENT

RHINOSPORIDIOSIS

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CT PNS

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IN#ESTIGATIONS

ROUTINE BLOOD IN#ESTIGATIONS

ECG

&RAY PNS

CTPNS

DNE

MANAGEMENT

ENDOSCOPIC COBLATION

EXCISION

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THAN% YOU