Postnasal Drip

Abstract

Middle aged male presented to General medicine OPD with a past history of nasal congestion and episodes of cough with breathlessness off and on especially during the winter months for the past few years. He had been seen by many practitioners and advised oral antiallergics (antihistamines and leukotriene receptor antagonists) and nasal steroid sprays. He was using inhalational corticosteroid-bronchodilator combination intermittently as well. Presently he gave a recent history of common cold and rhinorrhea for which he had received a 5-day course of oral Azithromycin and antihistamines. He was symptomatically better but continued with symptoms especially episodes of cough more during night time when he would wake up and had to clear his throat again and again. On oropharyngeal examination he was found to have a thick white streak of post nasal drip (see Pic). He was managed with fluticasone + Azelastine nasal spray and oral decongestants, with a good response and almost complete resolution of symptoms and clearance of the postnasal drip.