Extremely dry inside nose - could I have this disease?

Please any advice.  I have been to 3 different ENTs, the 1st one tested me for staph - came back moderate staph (not MRSA) and took Keflex for 10 days-no improvement.  Five days later cultured again and it came back negative.  Said I should use Bacitracin for a year as Bactroban burned and dismissed me.(I am allergic to all antibiotics but two and most other drugs-happens over time)
2nd ENT said Bacitracin irritates and easy to get allergic to it.  Already allergic to Neosporin.  She said my nose is extremely dry causing the scabs, crusting and rawness.  Even feels sore down the back of my nose into the throat area now.  Said to use saline spray and lots of saline gel and drink a lot of water as I am dry all over.  I did find out I am very allergic to molds, grass and tree pollen and started allergy shots 3 months ago but have gotten worse since last year when this all started.  Always raked leaves with no problem before that.  Now I need a mask to vacuum and 7 years ago had professional mold remediation done in the house.. .
3rd ENT also saidmy nose was very dry (everything is dry, skin, mouth, bottom), and said he thinks I have WEGENER'S GRANULOMATOSIS and removed a scab to look at the skin under and said it looked red but OK and did some blood tests cANCA & pANCA (negative), ANA (came back speckled), sed rate (OK), RA (negative) and said I need a biopsy of my nose and to use saline gel and Vaseline.  If I am a carrier of staph wouldn't Vaseline being occlusive keep the germs in the sore areas and cause an infection?  He really scared me as I looked it up on the internet and it seems to be a death sentence.  I told my PCP and she said I would not be able to tolerate those medications if I do have WG. (I am 74, 109 lbs, with Crohns disease,osteoporosis and osteoarthritis). Renal blood tests and CBC were OK.

I do like the 2nd ENT the most but she never suggested I might have WG -could 3rd ENT be overkill.  Almost too anxious to biopsy.

Thanks.

[David Tinkelman, M.D.]

It would be wise to get confirmation that you truly are a chronic Staph carrier before proceeding with antibiotic or any other therapy.  Even if the nasal cultures are inconstantly positive for Staph, you would ideally want to consult with an Infectious Disease consultant before initiating chronic treatment.

The nasal dryness you describe is also consistent with a condition called, atrophic rhinitis.  A great number of therapies have been reported in the medical literature but it is my understanding that there is no truly definitive treatment of this condition.

However, given the divergence of opinions expressed by your ENT’s, you might want to consider requesting consultation at a University Medical Center staffed by physicians with a specific interest in problems such as yours and extensive experience in the management of this condition.

The following is a report from such an institution.  I suggest that you either arrange for an appointment in this clinic or call the author of the report for recommendations of other physician groups, located closer to where you live.

Good luck,


Authors Greiner AN. Meltzer EO.

Authors Full Name Greiner, Alexander N. Meltzer, Eli O.
Institution Allergy and Asthma Medical Group and Research Center, 5776 Ruffin Road, San Diego 92123 Suite B, San Diego, CA 92123, USA. ***@****

Title Overview of the treatment of allergic rhinitis and nonallergic rhinopathy. [Review]


Source Proceedings of the American Thoracic Society. 8(1):121-31, 2011 Mar.
Abstract Allergic rhinitis (AR) and nonallergic rhinopathy (NAR) represent common nasal conditions affecting millions of individuals across the world. Although patients present with similar symptomatology, those with NAR are frequently affected only after childhood and present with a lack of other comorbid atopic disorders such as asthma, atopic dermatitis, and food allergies. Patients with pure NAR usually have no identifiable specific allergen sensitivity, whereas those with mixed (allergic and nonallergic) rhinitis are sensitized to aeroallergens in a manner that does not fully explain the duration or extent of their symptoms. This review presents the diverse options of currently available pharmacologic agents for the treatment of AR and NAR, including intranasal corticosteroids, H(1)-antihistamines, decongestants, cromolyn sodium, antileukotrienes, anticholinergics, capsaicin, anti-IgE, and intranasal saline, in addition to subcutaneous immunotherapy. Furthermore, treatment algorithms for AR and NAR are presented with a stepped-up, stepped-down scheme to aid the clinician in choosing appropriate therapy.
Publication Type Comparative Study. Journal Article. Review.
Date Created 20110302
Year of Publication 2011
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[suggi]

Re: Extremely dry nose - disease referred to is Wegener's Granulomatosis.