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Clinical Practice

Spontaneous cerebrospinal rhinorrhoea: a guide for primary care

Katy McFadyen and Andrew Whymark
British Journal of General Practice 2021; 71 (703): 90-91. DOI: https://doi.org/10.3399/bjgp21X714881
Katy McFadyen
Wards Medical Practice, Kilmarnock.
Roles: GP specialty trainee 1
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Andrew Whymark
NHS Ayrshire and Arran, Crosshouse.
Roles: ENT consultant and clinical director head and neck surgery
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INTRODUCTION

A 56-year-old female patient presented with a productive cough and intermittent fever for 3 weeks. On further questioning, she reported a nasal drip. She is a non-smoker. Prior to face-to-face assessment, she was screened for potential contact with coronavirus 19 (COVID-19). Of note, the patient reported symptoms consistent with COVID-19 but did not qualify for testing at that time. During the first face-to-face consultation, she was diagnosed with presumed viral illness and rhinitis. She was advised on self-care strategies and started on a steroid nasal spray.

EXAMINATION AND FURTHER PRESENTATIONS

The patient subsequently presented a further eight times over the next month. This was mostly telephone encounters due to the initiation of ‘lockdown’ and restrictions on face-to-face contact. The symptoms were not progressive. The fever settled and the cough became dry. Throughout, there was persistent rhinorrhoea, worse at night, forcing the patient to sleep upright. Examination was limited, given the nature of encounters, and only basic ear, nose, and throat (ENT) examination was carried out (limited intranasal examination). Bloods and chest X-ray were …

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British Journal of General Practice: 71 (703)
British Journal of General Practice
Vol. 71, Issue 703
February 2021
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Spontaneous cerebrospinal rhinorrhoea: a guide for primary care
Katy McFadyen, Andrew Whymark
British Journal of General Practice 2021; 71 (703): 90-91. DOI: 10.3399/bjgp21X714881

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Spontaneous cerebrospinal rhinorrhoea: a guide for primary care
Katy McFadyen, Andrew Whymark
British Journal of General Practice 2021; 71 (703): 90-91. DOI: 10.3399/bjgp21X714881
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    • INTRODUCTION
    • EXAMINATION AND FURTHER PRESENTATIONS
    • DIAGNOSING SPONTANEOUS CEREBROSPINAL RHINORRHOEA
    • UNCERTAINTY AND COVID-19
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More in this TOC Section

  • Anosmia: an evidence-based approach to diagnosis and management in primary care
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Print ISSN: 0960-1643
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