The breath is rancid
Introduction
Introduction Breathing gas is rancid because of the growth of bacteria under the purulent sputum, and the protein in the purulent septic decomposition, which produces a foul odor. Atrophic rhinitis is a slow-developing nasal atrophic inflammation characterized by atrophy of the nasal mucosa, periosteum, and bone. Severe with a typical bad smell, called ozena. More often than adolescence, women are more common than men. It is characterized by dryness, atrophy of the nasal mucosa, enlargement of the nasal cavity, dysosmia, a large number of yellow-green pus in the nasal cavity, and a stench of odor.
Cause
Cause
The cause is still unknown. There are many kinds of doctrines, which can be summarized into two categories:
(1) Primary: It is considered to be a partial manifestation of systemic diseases, which may be related to the lack of lipids and fat-soluble vitamins, or to nutritional disorders, lack or imbalance of trace elements, genetic factors, collagen diseases, etc. May have a certain relationship with endocrine disorders, because more often in young women, and increased symptoms during menstruation. In recent years, with the development of immunology, most patients with this disease have been found to have immune dysfunction, so some people believe that this disease may be an immune disease.
(B), secondary: caused by local factors, such as nasal mucosa suffered trauma or excessive surgical resection, or due to special infectious diseases such as tuberculosis, induration, leprosy, syphilis and so on. In the advanced stage of chronic hypertrophic rhinitis, or long-term purulent sputum stimulation of chronic suppurative sinusitis, excessive proliferation of fibrous connective tissue occurs, resulting in obstruction of blood circulation of the nasal mucosa and atrophy due to nutritional disorders. The nasal septum is extremely deflected, one side of the nasal cavity is wide, the stimulation of the enhanced airflow, or the long-term stimulation of dust or harmful gases can also cause disease. It has been suggested that the disease is caused by a special bacterial infection such as Rhizoctonia solani or diphtheria-like infection. It is believed that these bacteria are not true pathogens and are only secondary infections of atrophic rhinitis.
Examine
an examination
Nasal endoscopy
It can be seen that the nasal cavity is spacious, and the nasopharynx can be directly seen from the front nostril. The turbinate shrinks, the inferior turbinate is sometimes too small to be recognizable, and the middle armor is sometimes slightly hypertrophied or polypoid. The nasal mucosa is covered with gray-green suede, which can smell a special odor. A little empyema can be seen at the end of the molting, and the mucous membrane is red or pale. The pharyngeal mucosa is also congested and dry, sometimes covered with purulent sputum. In severe cases, the mucosa of the larynx also changes atrophic.
Nasal secretion culture
Commonly, Rhizoctonia solani and diphtheria-like bacilli are not really pathogenic bacteria.
X-ray film and CT examination
It can be seen that the turbinate is narrowed, the nasal cavity is widened, and the sinus can be poorly developed.
Diagnosis
Differential diagnosis
It should be differentiated from nasal tuberculosis, syphilis, leprosy and cheese rhinitis.
(A), nasal and nasopharynx dryness: This is due to atrophy of the glands of the nasal mucosa, resulting in decreased secretions.
(B), nasal congestion: purulent sputum block the nasal cavity can cause nasal congestion, or because the nerves of the nasal mucosa are slow, even if the purulent sputum is removed, the air is not easy to detect, and mistaken for nasal congestion.
(C), nasal secretions: often blocky, tube-shaped purulent sputum, not easy to sputum, when forced out of dryness, there is a small amount of nosebleeds.
(4) Olfactory Disorder: The sense of smell is reduced or disappeared. This is caused by atrophy of the olfactory mucosa or obstruction of dryness.
(5), exhaled stench: due to the growth of bacteria under the purulent sputum, the protein in the purulent sputum decomposes, producing a foul odor, called the stinky nose.
(6), headache, dizziness: due to atrophy of the turbinate, the nasal cavity lacks the effect of temperature regulation and heat preservation, inhaling cold air to stimulate the nasal mucosa, and the stimulation of purulent sputum can cause headache and dizziness.
