Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with a classic triad of chronic rhinosinusitis with nasal polyposis, asthma, and recurrent respiratory reactions following ingestion of aspirin or other COX-1 inhibitors. Symptoms include progressive nasal congestion, anosmia, and episodic bronchospasm. Patient reports [number] exacerbations per year, often triggered by NSAID exposure, characterized by rhinorrhea, ocular injection, and wheezing.
Clinical Examination Findings
HEENT: Significant nasal polyposis noted on anterior rhinoscopy; pale, edematous turbinates. Lungs: Bilateral expiratory wheezing, diminished air entry in lower lobes. Skin: No evidence of urticaria or angioedema at present. Vitals: Stable, O2 saturation [percentage]% on room air.
Treatment Protocol
Management plan: 1. Strict avoidance of all NSAIDs and COX-1 inhibitors. 2. Optimization of asthma control with ICS/LABA combination therapy. 3. Intranasal corticosteroids and saline irrigation for polyposis. 4. Consider aspirin desensitization protocol if clinically indicated. 5. Leukotriene receptor antagonists (LTRAs) initiated.