Differentiating Viral vs Bacterial vs Allergic

Viral: Symptoms last <10 days Bacterial: Symptoms lasting over < 10 days or getting worse after 5 days; severe symptoms Allergic: Seasonal, itchy eyes, related to exposure (only at home / outside), family history of allergy / atopy

Character Conditions Watery/mucoid Allergic, viral, CSF leak, vasomotor rhinitis Mucopurulent (+/- offensive odour) Bacterial rhinitis / sinusitis, foreign body (especially if unilateral discharge) Serosanguineous (blood tinged) Neoplasia Bloody (epistaxis) Spontaneous rupture of blood vessel in nasal mucosa (most common), trauma, neoplasia, hypertension, vascular disease, bleeding disorder

Symptom Associated Conditions Sneezing Allergic / infective rhinitis Facial tenderness Sinusitis Facial pain (interior of nose, paranasal sinuses) Trigeminal nerve pathology Middle ear abnormalities / otalgia (ear pain) Eustachian tube dysfunction Hearing Loss Middle ear effusion secondary to Eustachian tube dysfunction

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